Better Understanding the Context of Diabetes and Universal Health Coverage: Country case studies

This report from Health Action International's ACCISS Study presents the findings for country surveys looking at diabetes and UHC in eight countries representing different geographic regions and income groups.

In the lower income countries, availability of essential diabetes services is not assured, particularly for insulin supplies, glucose control and even for insulin itself. The existence of national noncommunicable disease (NCD) or diabetes programmes and inclusion in the essential service package or essential medicines list does not guarantee availability of diabetes services, especially at the primary healthcare level. Likewise, theoretical cost coverage by health insurance systems does not guarantee effective service provision with minimal out-of-pocket payments. Insulin supplies and blood glucose self-monitoring devices are often, in practice, poorly covered by health insurance systems. Health providers in lower-income countries tend to limit service for costly supplies or impose substantial user charges. Thailand has successfully provided essential diabetes care services free of charge, fully funded by health insurance schemes, without any restrictions.