27 October 2009

1. 27 October 2009 Policy Briefs Workshop: Framing Options - Roundtable EVIPNet Policy Briefs Workshop Santiago, Chile

2. Q1: What Are the Options? (ARG) • Framing the options to improve diabetes management in Buenos Aires province • Introduce a training program to improve diabetes management at the primary healthcare level (and improve clinical services in health centres and laboratories) • Strengthen the system of referrals among the three levels involved in diabetes management • Provide management training to those in leadership positions in each of the levels • Review and improve the entire process of referrals, including the allocation of staff to particular shifts, appointment scheduling, and how staff turn-over is handled • Strengthen the regional program and support integration with related national programs

3. Q1: What Are the Options? (MEX) • Framing options to improve adherence to norms and guidelines for the management of diabetes • Change undergraduate medical curricula to provide the skills needed to find, assess and use guidelines in primary healthcare • Promote and support the use of diabetes guidelines by physicians starting their primary healthcare practice (and those already working in primary healthcare practices) • Introduce a financial incentive for adherence to high-priority (diabetes) guidelines

4. Q1: What Are the Options? (COR) • Framing options to improve the quality of care provided to diabetics, esp. at the secondary level • Raise awareness among and train staff to support their adherence to diabetes norms and standards • Improve the third-party assessments systems to give greater attention to adherence to norms and standards, and support the use of existing financial incentives to make improvements in areas prioritized through the third-party assessments (and improve in-house assessments as well) • Support self-management by providing training to patients and their families and by improving community resources to support them

5. Q1: What Are the Options? (PAR) • Framing options to improve secondary prevention among diabetes, particularly among excluded groups • Communication campaigns targeted both at patients (respecting ethno-cultural and language differences) and at providers, with leadership from communication units in each of the 17 regions • Provide training at the local, regional and national levels to support self-management by patients and their families, the use of guidelines by healthcare providers (including health promoters), and the management of diabetes programs and services in line with nat’l norms • Introduce financial incentives to promote adherence to diabetes guidelines

6. Q1: What Are the Options? (FEP) • Framing options to reduce risk factors for and complications from diabetes • Do nothing (status quo) • Support community health workers in improving their reach and impact (in providing programs and services that have been shown to be effective) • Increase use of mobile trailers to provide effective programs and services to hard-to-reach diabetics

7. Q1: What Are the Options? (BRA) • Framing options to reduce neonatal mortality from gestational diabetes • Increase the participation of communities in supporting the widespread use of more effective programs and services for diagnosing and managing gestational diabetes • Supporting changes in the clinical management of gestational diabetes • Enhance the monitoring and evaluation of gestational diabetes

8. Other Observations • Options can include one or many option elements • Status quo is always an option (whether it’s stated as an option or is the comparator against which other options are compared)