Health literacy interventions at the service delivery/institutional level: country examples Amy Israel Global Health Thought Leadership & Policy Director Eli Lilly on behalf of International Federation of Pharmaceutical Manufacturers & Associations (IFPMA)
WE ASPIRE TO FUNDAMENTALLY CHANGE CARE IN RESOURCE-LIMITED SETTINGS OPERATING PRINCIPLE Develop patient-centered models to expand access to care and improve outcomes closer to the primary care level in resource-limited settings DISEASE AREAS MDR-TB Apply learnings, ensure linkages Diabetes Cancer INTERVENTION AREAS Design chronic care models for community and primary health care settings Advocate for scaling up successful models and implementing policies changes to improve access to chronic care GEOGRAPHIES 2 2
NEXT FIVE YEARS: EIGHT COUNTRIES AND THREE DISEASES DIABETES CANCER MDR-TB Brazil China India Kenya Mexico Russia South Africa United States Enhancing capacity at primary care level for early diagnosis and management of diabetes and cancer Developing a model to improve treatment demand and access to care through provider and nurse training Building on diabetes and TB learnings to prove a treatment adherence and support model in public and private settings for diabetes and hypertension. Testing innovative models of care to support early detection and treatment for breast and cervical cancers Supporting the national implementation of CASALUD primary care model and using system-wide data for improving diabetes care in the country s two largest health systems Bringing TB levels down in one oblast to that seen in Western Europe, and developing a model of care for diabetes focusing on the role of the primary care physician Expanding diabetes care model to integrate HIV, TB, maternal and child health; building on our tuberculosis efforts to overlay diabetes hypertension care onto TB treatment programs Piloting new ways of improving diabetes prevention and care through a neighborhood-based approach in Indianapolis, Indiana 3
TARGETING SPECIFIC PAIN POINTS ALONG PATHWAYS OF CARE Program intervention Program intervention Program Intervention 4 LTFU=Loss-to-follow-up
IMPACT TO DATE Diabetes Improved access to diabetes care in Mexico through a comprehensive primary care model. Adherence to treatment increased with more than 70% of patients in two states participating in support groups. National rollout of this model is underway. Identified over 70,000 people with diabetes or hypertension in India and developed information, education and communication materials now being adopted by the Ministry of Health. Developed and tested primary care guidelines and provider training toolkit and a type 1 diabetes toolkit for providers, parents and children in Brazil, which are now being considered for broader rollout by the Ministry of Health. Tested community-based diabetes and hypertension screening approaches in South Africa, providing data on both the prevalence of these conditions and loss-to-follow-up between screening and treatment initiation. 5
SHARING PROGRESS AND LEARNINGS ALONG THE WAY We are tracking a standardized set of indicators across programs which are focused on the pain points along the patient pathway we are working to address, including: Outputs Outcomes # Individuals screened # Individuals diagnosed # Individuals on treatment # Facilities activated to provide screening, diagnosis and treatment services # individuals with controlled diabetes # individuals with controlled hypertension # individuals implementing lifestyle change by meeting recommended levels of physical activity, dietary changes 6
Integrating diabetes and hypertension care into TB platforms INDIA Case Study in Chennai Chennai
Private sector health care providers are critical to reaching people
Interventions at the Nakshatra Center
Private health sector engagement for integration
Integrated healthcare delivery for patients in the private sector TB symptoms TB patient Household contacts TB Screening & diagnosis Diabetes & Hypertension Screening & Diagnosis
Health literacy interventions at the service delivery/institutional level: country examples Amy Israel israel_amy@lilly.com Global Health Thought Leadership & Policy Director Eli Lilly on behalf of International Federation of Pharmaceutical Manufacturers & Associations (IFPMA)