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Integration of NCDI Services Policy Brief

Progressive Decentralization and Integrated Care Teams –
Keys to Bridging the Gap in Services for NCDs and Injuries

Non-communicable diseases and injuries (NCDIs) account for a large and growing proportion of the burden of disease in all World Health Organizations (WHO) regions, including in low- and lower-middle-income countries (LLMICs). Among the world’s poorest billion people, NCDIs cause almost 800,000 deaths under the age of 40 every year – more than HIV, tuberculosis, and maternal deaths combined.

Proven, cost-effective, and equitable NCDI interventions exist that could save millions of lives each year, if scaled to reach everyone in need. But in many LLMICs, these interventions are available only at referral hospitals in capital cities, which makes them inaccessible and unaffordable for the rural poor.

The key to achieving both Universal Health Coverage and Sustainable Development Goal targets for reducing mortality from NCDIs is to develop and implement strategies for progressive decentralization and integrated service delivery that can deliver these interventions, with quality, at lower levels of the health system and in rural areas.

Integration and PEN-Plus policy brief_w_CIS&Network_logos

Experience of living with type 1 diabetes in a low-income country: a qualitative study from Liberia

Alma J Adler, Celina Trujillo, Leah Schwartz, Laura Drown, Jacquelin Pierre, Christopher Noble, Theophilus Allison, Rebecca Cook, Cyrus Randolph, Gene Bukhman

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Despite the severe nature of T1D and growing burden in sub- Saharan Africa, little is currently known about the impact of T1D on patients and caregivers in the region. We conducted a qualitative study consisting of interviews with patients with T1D, caregivers, providers, civil society members and a policy-maker in Liberia to better understand the psychosocial and economic impact of living with T1D, knowledge of T1D and self-management, and barriers and facilitators for accessing T1D care.

T1D was found to have a significant impact on patients and caregivers, and informants identified several key individual and systems-level barriers to effective T1D care in Liberia. Addressing these concerns is vital for designing sustainable and effective programmes for treating patients living with T1D.