Health Delivery

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Preparing a global healthcare workforce for the challenge of chronic conditions

Chronic conditions are increasing. The number of people affected by chronic non-communicable conditions, including diabetes and heart disease, is growing worldwide. Collectively, chronic conditions were responsible for 35 million – a full 60% – of all deaths in 2005. This is twice the number of deaths due to infectious diseases, poor maternal health and malnutrition combined. In addition to causing high death rates, chronic conditions account for almost half of the world’s disability.

Managing chronic disease as a team - new models of care delivery

As the world’s population ages, the impact of chronic diseases will drive health systems around the world in two ways – adding significantly to the cost, and imposing considerable constraints on the already strained healthcare workforce. It is estimated that the health budgets of most developed nations will consume 20% of their gross domestic product by the 2020s. The most recent World Health Organization Health Workforce Report suggests shortfalls of some 4.3 million healthcare workers over the next decade – including nurses, doctors and health administrators.

Improving self-efficacy in the search for cost-effective solutions - the Indonesian experience

The burden of diabetes has increased dramatically in most developed countries and in many developing countries. People’s perceptions and knowledge about their diabetes, as well as other psychological factors, are important predictors for the success of diabetes self-management. Indonesia’s population of more than 240 million people faces a wide range of health problems – both communicable and non-communicable diseases – which are placing a huge burden on the country’s healthcare sector.


Enhancing literacy and life skills among people with diabetes in Argentina

Around 780 million adults worldwide – most of them living in developing countries – are locked into a life of isolation and poverty because they cannot read or write. In people with diabetes, low literacy severely complicates the day-to-day management of their condition or, indeed, entirely precludes effective self-care – in many cases leading to tragic consequences.


The Alphabet Strategy: an evidence-based approach to diabetes care

Meeting the needs of people with diabetes is complicated and demanding for both people with the condition and their healthcare providers. Moreover, diabetes is expensive, and costs are rising worldwide. Diabetes healthcare providers in all

Addressing barriers to care in elderly African-American women in rural areas

Diabetes is a major health concern; 246 million people are diagnosed and living with the disease worldwide. The growing global prevalence of type 2 diabetes is correlated with the ongoing rise in obesity. In the USA, where diabetes is the fifth-leading cause of death, the number of people with the condition has tripled in the last 30 years. The number of people with the condition is set to increase in coming years as populations age.

Small-scale strategies to improve diabetes awareness in those who need it most

After only a few hours at an outpatient diabetes clinic in Tanzania, it becomes apparent to any observer that most people with diabetes arrive unaccompanied. The lack of affordable transportation forces people to visit the clinics alone. Unfortunately, such behaviour not only fosters a lack of support from the family but also creates a gap between the family and the healthcare provider. When it comes to managing diabetes at a population level, a team approach is necessary that includes people with diabetes, their family and their healthcare providers.

Why I adopted a reduced carbohydrate approach

Having lived with diabetes for many years, Ron Raab noticed that when he reduced the amount of carbohydrate in his diet, his blood glucose levels improved. His experience of the shortcomings of high-carbohydrate dietary recommendations in regulating his blood glucose led him to adopt an alternative approach. In this article, the author outlines his choice of a much reduced carbohydrate dietary intake as a key element of his diabetes management.

The Steno Diabetes Center: from education to action

The Steno Diabetes Center was founded in 1932. It has since been a leading player in the struggle against diabetes through clinical care and development, and wide research activities. During the 1980s, the paternalistic model of care was shown to be inadequate to cover the demands of people with diabetes. The need for coaching, learning and education became clear. A team approach was gradually developed, involving nurses, dietitians and foot specialists, as well as physicians.

Lifestyle education for children - some useful strategies

In many cases, overweight and obesity in children constitute a grim warning for future health: if no action is taken, an overweight or obese child is likely to grow into an overweight or obese adult with a series of chronic health problems – among them, type 2 diabetes. Indeed, obesity-related health conditions, including the metabolic syndrome – a strong risk factor for cardiovascular diseases – are increasingly prevalent among children around the world.

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