Systems Science for Caribbean Health: the development and piloting of a model for guiding policy on diabetes in the Caribbean

Health Res Policy Syst. 2016 Oct 26;14(1):79. doi: 10.1186/s12961-016-0150-z.

Abstract

Background: Diabetes is highly prevalent in the Caribbean, associated with a high morbidity and mortality and is a recognised threat to economic and social development. Heads of Government in the Caribbean Community came together in 2007 and declared their commitment to reducing the burden of non-communicable diseases (NCDs), including diabetes, by calling for a multi-sectoral, systemic response. To facilitate the development of effective policies, policymakers are being engaged in the development and use of a system dynamics (SD) model of diabetes for Caribbean countries.

Methods: Previous work on a diabetes SD model from the United States of America (USA) is being adapted to a local context for three countries in the region using input from stakeholders, a review of existing qualitative and quantitative data, and collection of new qualitative data. Three country models will be developed using one-on-one stakeholder engagement and iterative revision. An inter-country model will also be developed following a model-building workshop. Models will be compared to each other and to the USA model. The inter-country model will be used to simulate policies identified as priorities by stakeholders and to develop targets for prevention and control. The model and model-building process will be evaluated by stakeholders and a manual developed for use in other high-burden developing regions.

Discussion: SD has been applied with success for health policy development in high-income country settings. The utility of SD in developing countries as an aid to policy decision-making related to NCDs has not been tested. This study represents the first of its kind.

Keywords: Developing countries; Diabetes; Health policy; Non-communicable disease; Policy simulation; System dynamics modelling.

Publication types

  • Evaluation Study

MeSH terms

  • Caribbean Region
  • Developing Countries
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / therapy*
  • Government
  • Health Policy*
  • Humans
  • Models, Biological*
  • Pilot Projects
  • Policy Making*
  • Prevalence
  • Science
  • Systems Analysis*
  • United States