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Articles by D. Beran
Total Records ( 2 ) for D. Beran
  D. Beran , C. Silva Matos and J. S. Yudkin
  Objective  To assess improvements in diabetes care in Mozambique between 2003 and 2009 following the implementation of the Diabetes UK Twinning Programme.

Methods  As in 2003, a Rapid Assessment Protocol was implemented from August to September 2009 in order to assess the improvements in diabetes care and impact of the Diabetes UK Twinning Programme. One hundred and eighty-four interviews were carried out at different levels of the health system in different areas of Mozambique.

Results  The Diabetes UK Twinning Programme in Mozambique allowed the development of the first comprehensive non-communicable disease plan in sub-Saharan Africa. The other main improvements include a strengthening of the diabetes association with an 8-fold increase in membership, 265 health workers trained in diabetes care in all provinces, the development of patient education materials inspired by some Diabetes UK tools and the expansion of public awareness, particularly from events associated with World Diabetes Day.

Conclusions  Much progress has been made in Mozambique with regard to diabetes and non-communicable diseases. Besides the direct impact of specific activities supported by Diabetes UK, this project allowed for ‘collateral’ benefits in the overall provision of diabetes care. As diabetes and non-communicable diseases have a low profile on the global health agenda, twinning partnerships based on rigorous needs assessment have the capacity to make significant improvements in diabetes care at a relatively low level of investment. Moreover, this study suggests that the tool used might be of value in assessing progress in health system strengthening as well as in conducting the initial needs assessment.

  D. Beran


The aim of this study was to use the concept of Maslow's hierarchy of needs and apply this to Type 1 diabetes.


Qualitative methods were employed using semi-structured interviews with 101 people from 13 countries. Grounded theory was used for data collection and analysis, with thematic analysis employed to identify the interviewees' needs.


Sixteen needs were identified and links between these were mapped. Aligning these with Maslow's hierarchy allowed for a hierarchy to be developed for Type 1 diabetes with ‘Policies’, ‘Organization of health system’, ‘Insulin’, ‘Delivery of insulin’, ‘Control’, ‘Healthcare workers’ and ‘Information and education’ at the base, as they were needed for survival. Next came ‘Community, family and peers’ and changing roles for ‘Healthcare workers’ in their approach to care and delivering ‘Information and education’. This enabled people to learn how to use ‘Insulin’, ‘Delivery of insulin’ and ‘Control’ flexibly. People’s ‘Experience’ and ‘Personality’ then helped them ‘Adapt’ and ‘Be open’ about their diabetes, allowing for ‘Acceptance’ and viewing ‘Diabetes as something positive’.


Despite limitations, this work highlights that some needs are required for survival and others for well-being. Some are tangible as they can be directly provided, whereas others are intangible and cannot be provided directly by the health system. These results might be used for policy and practice in identifying needs that are met within a health system or what needs are lacking for the individual to then implement targeted interventions.

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