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CRONICAS Report: Barriers for Access

“The findings described allow for an understanding of patients’ primary barriers to care and access to medication with arterial hypertension and/or diabetes, mainly with regard to access to medical appointments, the difficulties faced in access to and the scarce accessibility to medication, the problems of reduced treatment adherence, and the difficulties in obtaining access to laboratory exams in primary care facilities and the self-monitoring equipment needed for control their arterial blood pressure and glucose.”

In 2014, CRONICAS Center of Excellence in Chronic Diseases at Universidad Peruana Cayetano Heredia (UPCH), with support from the Alliance for Health Policy and Systems Research of the World Health Organization and the University of Geneva, published a study to identify the barriers to access to medication and care for patients with arterial hypertension and diabetes. The aim of this work is to influence the development of proposals to strengthen the Peruvian health system in order to foster responsive policies that contribute to better health for people diagnosed with these diseases.

The mixed methods analysis incorporated findings from key informant interviews with various levels of the health system, including the Ministry of Health, practitioners from health facilities, directors of Social Health Insurance (EsSalud), and patients living with diabetes and arterial hypertension.

Findings in the report were organized into the following ten sections:

  • The Peruvian health system and National Health Strategy for the Prevention and Control of NCDs
  • Clinical management of arterial hypertension and diabetes
  • Participation of patients and personnel in related programs
  • Health insurance coverage for patients
  • Organization of primary health care and access to medical appointments
  • Problems in obtaining access to medication
  • Affordability of medication
  • Patients with reduced treatment adherence
  • Problems with obtaining access to laboratory exams
  • Self-monitoring of arterial pressure and glucose levels