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01.12.2017 | Research | Ausgabe 1/2017 Open Access

Globalization and Health 1/2017

Addressing the double-burden of diabetes and tuberculosis: lessons from Kyrgyzstan

Zeitschrift:
Globalization and Health > Ausgabe 1/2017
Autoren:
Jolene Skordis-Worrall, Jeff Round, Matthias Arnold, Aida Abdraimova, Baktygul Akkazieva, David Beran

Abstract

Background

The incidence of diabetes and tuberculosis co-morbidity is rising, yet little work has been done to understand potential implications for health systems, healthcare providers and individuals. Kyrgyzstan is a priority country for tuberculosis control and has a 5% prevalence of diabetes in adults, with many health system challenges for both conditions.

Methods

Patient exit interviews collected data on demographic and socio-economic characteristics, health spending and care seeking for people with diabetes, tuberculosis and both diabetes and tuberculosis. Qualitative data were collected through semi-structured interviews with healthcare workers involved in diabetes and tuberculosis care, to understand delivery of care and how providers view effectiveness of care.

Results

The experience of co-affected individuals within the health system is different than those just with tuberculosis or diabetes. Co-affected patients do not receive more care and also have different care for their tuberculosis than people with only tuberculosis. Very high levels of catastrophic spending are found among all groups despite these two conditions being included in the Kyrgyz state benefit package especially for medicines.

Conclusions

This study highlights that different patterns of service provision by disease group are found. Although Kyrgyzstan has often been cited as an example in terms of health reforms and developing Primary Health Care, this study highlights the challenge of managing conditions that are viewed as “too complicated” for non-specialists and the impact this has on costs and management of individuals.
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