Manual “How to investigate access to chronic Non Communicable Disease care in LMICs
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The global burden of noncommunicable diseases (NCDs) now contributes to greater loss of quality life-years than does that of all infectious diseases. This is the case for each individual region of the World Health Organization except Africa, but here, too, the burden of NCDs continues to rise. Health services in many low- and middle-income countries have evolved for the management of patients with acute infections, the constraining factors usually being poor availability of antibiotics or antimalarials, or of trained health workers. But the transition of disease burden from mainly acute to mainly chronic illness brings with it a
series of different challenges for the health-care system.
This challenge has been recognized by the global community with the United Nations High-Level Meeting on NCDs and the First Global Ministerial Conference on “Healthy Lifestyles and Noncommunicable Disease Control” in Moscow. The World Health Organization’s response has been the development and publication of an “Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases” and a “Prioritized Research Agenda for the Prevention and Control of Noncommunicable Diseases”. These two documents highlight the importance of health systems, health system research and researching issues around access to care in addressing the challenge of NCDs. In parallel, the Essential Medicines and Pharmaceutical Policies Department, World Health Organization, has carried out in-depth analyses of the affordability and availability of medicines for NCDs.
The International Insulin Foundation (IIF) was established in 2002 with the aim of prolonging the life and promoting the health of people with diabetes in resource-poor countries by improving access to diabetes care. In order to achieve this, it was felt necessary to undertake a clear analysis of the constraints to insulin access and diabetes care. This led the Foundation to develop the Rapid Assessment Protocol for Insulin Access (RAPIA). The purpose of a rapid assessment protocol is to gather information quickly, in situations where resources or logistical constraints make conventional research techniques impractical, and where assessments need to be tightly linked with developing interventions. The RAPIA has been implemented by the IIF in six countries with a further assessment carried out in the Philippines to test the Protocol and help in the development of this manual. Assessments using the RAPIA have addressed areas including organization of the health-care system, diagnostic tools, drug procurement and affordability, accessibility of care, health-care worker training, community involvement, and the policy environment. In all cases, the conduct and reporting of the RAPIA have enabled the development of targeted projects and/or national diabetes plans with measurable improvements in care resulting.
This manual will allow different stakeholders involved in NCDs in low- and middle-income countries to plan and conduct surveys to explore current patterns of, and barriers to, good management, and to make recommendations in a short timescale and with limited resources. While the guidelines for good management of people with NCDs may differ to only a small extent between different countries, approaches to improving care will depend heavily on the
existing patterns of care, resources and the barriers that exist in different countries. This manual is designed to support the development of country-specific plans by providing a practical tool that enables “research for action” in the area of NCDs.
A pilot of this Manual is currently being carried out in Peru looking at diabetes and hypertension. This project is being supported by the Alliance for Health Systems and Policy Research and carried out by CRONICAS centre, based at Universidad Peruana Cayetano Heredia in Lima Peru and the University of Geneva, Switzerland.
Click here to download a copy of the Manual
series of different challenges for the health-care system.
This challenge has been recognized by the global community with the United Nations High-Level Meeting on NCDs and the First Global Ministerial Conference on “Healthy Lifestyles and Noncommunicable Disease Control” in Moscow. The World Health Organization’s response has been the development and publication of an “Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases” and a “Prioritized Research Agenda for the Prevention and Control of Noncommunicable Diseases”. These two documents highlight the importance of health systems, health system research and researching issues around access to care in addressing the challenge of NCDs. In parallel, the Essential Medicines and Pharmaceutical Policies Department, World Health Organization, has carried out in-depth analyses of the affordability and availability of medicines for NCDs.
The International Insulin Foundation (IIF) was established in 2002 with the aim of prolonging the life and promoting the health of people with diabetes in resource-poor countries by improving access to diabetes care. In order to achieve this, it was felt necessary to undertake a clear analysis of the constraints to insulin access and diabetes care. This led the Foundation to develop the Rapid Assessment Protocol for Insulin Access (RAPIA). The purpose of a rapid assessment protocol is to gather information quickly, in situations where resources or logistical constraints make conventional research techniques impractical, and where assessments need to be tightly linked with developing interventions. The RAPIA has been implemented by the IIF in six countries with a further assessment carried out in the Philippines to test the Protocol and help in the development of this manual. Assessments using the RAPIA have addressed areas including organization of the health-care system, diagnostic tools, drug procurement and affordability, accessibility of care, health-care worker training, community involvement, and the policy environment. In all cases, the conduct and reporting of the RAPIA have enabled the development of targeted projects and/or national diabetes plans with measurable improvements in care resulting.
This manual will allow different stakeholders involved in NCDs in low- and middle-income countries to plan and conduct surveys to explore current patterns of, and barriers to, good management, and to make recommendations in a short timescale and with limited resources. While the guidelines for good management of people with NCDs may differ to only a small extent between different countries, approaches to improving care will depend heavily on the
existing patterns of care, resources and the barriers that exist in different countries. This manual is designed to support the development of country-specific plans by providing a practical tool that enables “research for action” in the area of NCDs.
A pilot of this Manual is currently being carried out in Peru looking at diabetes and hypertension. This project is being supported by the Alliance for Health Systems and Policy Research and carried out by CRONICAS centre, based at Universidad Peruana Cayetano Heredia in Lima Peru and the University of Geneva, Switzerland.
Click here to download a copy of the Manual