Content, Participants and Outcomes of Three Diabetes Care Programmes in Three Low and Middle Income Countries
(2014; 7 pages)

J. Van Olmen, et al., Content, participants and outcomes of three diabetes care programmes in three low and middle income countries, Prim. Care Diab. (2014), http://dx.doi.org/10.1016/j.pcd.2014.09.001

Resumen

Aims: To improve access and quality of diabetes care for people in low-income countries, it is important to understand which elements of diabetes care are effective. This paper analyses three diabetes care programmes in the DR Congo, Cambodia and the Philippines.

Methods: Three programmes offering diabetes care and self-management were selected. Programme information was collected through document review and interviews. Data about participants’ characteristics, health outcomes, care utilisation, expenditures, care perception and self-management were extracted from a study database. Comparative univariate analyses were performed.

Results: Kin-réseau (DR Congo) is an urban primary care network with 8000 patients. MoPoT-syo (Cambodia) is a community-based peer educator network, covering 7000 patients. FiLDCare (Philippines) is a programme in which 1000 patients receive care in a health facilityand self-management support from a community health worker. Content of care of the programmes is comparable, the focus on self-management largest in MoPoTsyo. On average, Kin-réseau patients have a higher age, longer diabetes history and more overweight. MoPoT-syo includes most female, most illiterate and most lean patients. Health outcomes (HbA1Clevel, systolic blood pressure, diabetes foot lesions) were most favourable for MoPoTsyopatients. Diabetes-related health care expenditure was highest for FiLDCare patients.

Conclusions: This study shows it possible to maintain a diabetes programme with minimal external resources, offering care and self-management support. It also illustrates that health outcomes of persons with diabetes are determined by their bio-psycho-social characteristics and behaviour, which are each subject to the content of care and the approach to chronic illness and self-management of the programme, in turn influenced by the larger context.

 
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