Identifying the barriers to access to treatment for diabetes and hypertension

The purpose of this project was to provide an overview of what is happening with the treatment provided to individuals suffering from non-communicable diseases, such as diabetes and hypertension by applying a rapid health assessment protocol tool provided by the World Health Organization.


The aim of this project is to identify barriers to access medication and treatment for non-communicable diseases in Peru, and to develop proposals for improvements in the health system, while establishing a policy response that will contribute to improve the health of people with non-communicable diseases in Peru.


The project consisted of piloting, for the first time in Peru, a research implementation manual for the evaluation of healthcare systems´ responses to chronic non-communicable diseases (available at

The project started in 2012 with the planning of the implementation. In 2013 the project was implemented in nine different health establishments affiliated to different institutions in Lima, such as the Ministry of Health (MINSA), EsSalud, the Armed Forces and the private sector. Other key players and specialists also participated by providing information. Examples of contributing key players are among others as representatives of the Peruvian Diabetes Association, the Peruvian Society of Hypertension and the MINSA National Strategy for Non-Communicable Diseases.

During the first implementation phase in Peru the instruments that were to be used were adapted to the characteristics of the Peruvian health system. Those instruments were designed to gather a mixture of qualitative and quantitative information depending on the type of informant.

In the second phase information was gathered. For two and a half months almost 140 interviews with patients, suppliers and key informants were conducted. During the interviews the patients with diabetes and/or hypertension were asked about the characteristics of the service and of the treatment they are receiving, the difficulties they face on a day-to-day basis, the availability of services and supplies required for treatment, as well as associated costs.




Maria Kathia Cárdenas


Lima, Peru

Lima, Peru


The Alliance for Health Policy and Systems Research (Alliance) – World Health Organization (WHO)



Research team

Jaime Miranda, MD, MSc, PhD, FFPH, María Kathia Cárdenas, BSc, MSc(c),  Dulce Morán, BA, David Beran, MSc, PhD.