Type 1 Diabetes

Equitable Care for People Living with Type 1 Diabetes: The PEN-Plus Model

Unlike their counterparts in high-income countries, children with type 1 diabetes in rural areas of sub-Saharan Africa often die within a year of diagnosis. This tragedy is as medically unnecessary as it is morally unconscionable.

To address inequities in care, the NCDI Poverty Network is working with 22 resource-poor countries around the world to implement PEN-Plus, an innovative, integrated-care delivery model for severe, chronic noncommunicable diseases such as type 1 diabetes, sickle cell disease, and childhood heart diseases. PEN-Plus clinics save the lives of those with type 1 diabetes, for example, by providing insulin and specialized care close to home, as well as money for food and transportation to the clinic.

“That night, my blood pressure got so high I started talking nonsense and passed out. My parents were terrified and took me to the health center. I was in a coma for five days before regaining consciousness. Symaque [A PEN-Plus nurse] taught me how to inject myself, so I could take my insulin to school with me.”

-Angelique Mukarakisa, a young woman living with type 1 diabetes in rural Rwanda