Imperial College London
Dr Lesong Conteh

DrLesongConteh

Faculty of Medicine, School of Public Health

Visiting Reader
 
 
 
//

Contact

 

+44 (0)20 7594 5029l.conteh

 
 
//

Location

 

32ANorfolk PlaceSt Mary's Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Cucunubá:2017:10.1016/j.socscimed.2017.01.002,
author = {Cucunubá, ZM and Manne-Goehler, JM and Diaz, D and Nouvellet, P and Bernal, O and Marchiol, A and Basanez, M and Conteh, L},
doi = {10.1016/j.socscimed.2017.01.002},
journal = {Social science & medicine},
pages = {187--198},
title = {How universal is coverage and access to diagnosis and treatment for Chagas disease in Colombia? A health systems analysis},
url = {http://dx.doi.org/10.1016/j.socscimed.2017.01.002},
volume = {175},
year = {2017}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Limited access to Chagas disease diagnosis and treatment is a major obstacle to reaching the 2020 World Health Organization milestones of delivering care to all infected and illpatients. Colombia has been identified as a health system in transition, reporting one of the highest levels of health insurance coverage in Latin America. We explore if and how this high level of coverage extends to those with Chagas disease, a traditionally marginalised population.  Using a mixed methods approach, we calculate coverage for screening, diagnosis and treatment of Chagas. We then identify supply-side constraints both quantitatively and qualitatively.   A review of official registries of tests and treatments for Chagas disease delivered between 2008 and 2014 is compared to estimates of infected people. Using the Flagship Framework, we explore barriers limiting access to care. Screening coverage is estimated at 1.2% of the population at risk.  Aetiological treatment with either benznidazol or nifurtimox covered 0.3–0.4% of the infected population. Barriers to accessing screening, diagnosis and treatment are identified for each of the Flagship Framework’s five dimensions of interest: financing, payment, regulation, organisation and persuasion. The main challenges identified were: a lack of clarity in terms of financial responsibilities in a segmented health system, claims of limited resources for undertaking activities particularly in primary care, non-inclusion of confirmatory test(s) in the basic package of diagnosis and care, poor logistics in the distribution and supply chain of medicines, and lack of awareness of medical personnel. Very low screening coverage emerges as a key obstacle hindering access to care for Chagas disease. Findings suggest serious shortcomings in this health system for Chagas disease, despite the success of universal health insurance scale-up in Colombia.  Whether these shortcomings exist in relation to other neglected tropical diseases need
AU  - Cucunubá,ZM
AU  - Manne-Goehler,JM
AU  - Diaz,D
AU  - Nouvellet,P
AU  - Bernal,O
AU  - Marchiol,A
AU  - Basanez,M
AU  - Conteh,L
DO  - 10.1016/j.socscimed.2017.01.002
EP  - 198
PY  - 2017///
SN  - 0037-7856
SP  - 187
TI  - How universal is coverage and access to diagnosis and treatment for Chagas disease in Colombia? A health systems analysis
T2  - Social science & medicine
UR  - http://dx.doi.org/10.1016/j.socscimed.2017.01.002
UR  - http://hdl.handle.net/10044/1/43791
VL  - 175
ER  -
Download