Real Situation on Association
Development, Social, Societal Aspects
and Patients’ Rights
in Eastern European Countries
International Diabetes Federation European Region
Annual Meeting 2006
Warsaw, Poland 3 – 5 November
Vida Augustiniene
Member of Board, IDF European Region
President, Lithuanian Diabetes Association
BACKGROUND AND AIMS
According to my initiative, a brief survey
on real situation on association
development, social, societal aspects and
patients’ rights has been performed in the
Eastern European Countries (Georgia,
Azerbaijan, Belarus, Kazakhstan,
Kirghizstan, Russia, Ukraine) in 2006.
MATERIALS AND METODS
Eastern European Countries Meeting ,,Association development
for a better life with diabetes” was organized in Tbilisi, Georgia,
12 – 13 May, 2006. Before the meeting I prepared and sent a
questionnaire to all 7 members of IDF – Diabetes Associations of
EEC:
• Azerbaijan Diabetes Society,
• Belarussian Humanitarian Organization,
• Georgian Union of Diabetes and Endocrine Associations,
• Diabetes Association of the Republic of Kazakhstan,
• Diabetes Association of Kirghizstan,
• Russian Diabetes Federation,
• Ukrainian Diabetyc Federation.
Questionnaire was prepared according
references:
•
•
•
•
•
•
Diabetes care and research in Europe: the St Vincent
Declaration action programme/edited by H. M. J. Krans,
M. Porta and H. Keen, Copenhagen: WHO, Regional
Office for Europe, 1992.
IDF Diabetes Atlas, 2000& 2003.
Together we are stronger, A Guide for Diabetes
Associations, IDF, 2000.
European Charter of Patients’ Rights, Active Citizenship
Network, 2002
Declaration on Patient-Centred Healthcare, International
Alliance of Patients’ Organizations, 2006.
www.idf.org
13 main questions were put in the
questionnaire:
1.
2.
3.
4.
5.
6.
Do you have any problems in your country
organizing activities of diabetes associations?
Do you need any help from IDF/ Europe?
What are your suggestions to IDF/Europe
Board for better cooperation with diabetes
associations of EEC?
Do you have National Diabetes Plan?
Is your organization recognized as equal
partner in making healthcare decisions in the
State institutions?
Does your organization publish the newspaper
(journal)?
13 main questions were put in the
questionnaire:
7. Do you have home page of organization on website?
8. Do people with diabetes have routinely free access to insulin
(animal, human, analogues), tablets? Which part of price of
medicine does the government reimburse?
9. How many blood glucose monitoring tests are free for people with
diabetes?
10. Do children and adolescents have the same social rights as their
non-diabetic fellows?
11. Do people with diabetes have routinely free access to diabetes
education, foot care, consultation of endocrinologist, oculist,
cardiologist, and other health specialists?
12. Do people with diabetes have unreasonable restrictions,
ignorance, prejudice to drivers’ licence, employment, life and
health insurance?
13. Do you have any comments on social, societal aspects and
patients’ rights in your country?
The results of survey were used:
• In Board Meeting of IDF European Region,
Brussels, 23 September, 2006
• Sent to 7 Patients’ Diabetes Organizations from
Eastern European Countries
SUMMARY OF SURVEY
I have got answers from all 7 Eeastern European countries:
•
•
•
•
•
•
•
Azerbaijan (M. Omarova),
Belarus (S. Zaharova),
Georgia (J. Schelestiova),
Kazakhstan (N. Tukalevskaja),
Kirghizstan (R.Sultanalijeva),
Russia { Moscow DA (E. Gustova), Russian DA (A.
Mayorov), All Russian DA (M. Bogomolov), St. Peterburg
DS (M. Schipulina),
Ukraine (V. Ocheretenko).
What is Real Situation on Associations
Development for a Better Life with Diabetes
in the 7 Eastern European Countries?
I. Development
S.
N.
1.
Questions/Answer
s
Do you have any
problems
in
country
organizing
activities
of
Diabetes
Associations?
Azerbaijan
DA
Bureaucracy
of
governmental
sector;
Lack of
coordination
among
Diabetes
Organizations
Belarussia
n
HO
Georgian
DU
Financial;
Only
Volunteer
work
Financial
Kazakhsta
n
DA
Kirghizstan
DA
Financial;
Low
activity
and
exploitati
ve
position
of
patients
Lack
of
information
;
Lack
of
National
register of
patients;
Lack
of
endocrinolo
gists,
diabetologi
sts
are’nt
Low
activity of
patients
Ukrainian
DF
Nonexistence
of Law for
NGO
Russian Diabetes Federation
Moscow DA
Russian DA
All Russian
DA
St.
Petersbu
rg DA
Bureaucrac
y
in all levels
of
governmen
t;
Conservatis
m of health
professiona
ls;
High prices
for rent;
Lack
of
support
from
businessme
n;
Low
activity and
exploitative
position of
patients
Financial;
Large
territory
–
difficulties to
organize
regional
meetings;
Lack
of
professionals
in RDA to
organize
contacts with
government;
Incomprehens
ion of society
the role of
patients
organizations
Passivity
of NDA,
formalism
of activity,
unformed
public,
interferenc
e for NGO
activity
from side
of
governme
nt
Lack of
relation
among
sectors
of
society,
difficult
ies for
NGO to
solve
social
problem
s
I. Development
Questions/A
nswer
s
S.N.
2
Do
you need
any
support
from
IDF/Euro
pe?
Azerbaijan
DA
More round
table
discussions,
sessions in
countries
Belarussi
an
HO
Grants;
Joint pro
jects
Georgia
n
DU
Financia
l
Policy
(continue)
Kazakhs
ta
n
DA
Kirghizsta
n
DA
Financial
,
Institutio
n,
Informat
ion
Informati
on
from IDF
in Russian
Ukrainia
n
DF
Informati
on,
Methodic
al,
Grants
for
managers
of NDA
Russian Diabetes Federation
Moscow DA
Russian DA
Information,
Grants for
National
projects
More
information
Training courses
for
representatives
of NDA about
development of
organizations;
Grants for
National
projects
All Russian
DA
We do not
expect any
support
I. Development
S.
N.
Questions/Answ
ers
3
What are your
suggestions
to
IDF/Europe
Board for better
cooperation with
Diabetes
Associations
of
EEC?
Azerbaijan
DA
More
EEC
support
to
(continue)
Belarussi
an
HO
Georgia
n
DU
Kazakhs
tan
DA
Kirghizsta
n
DA
Ukrainia
n
DF
Prolongat
ion
of
Annual
Meetings
of EEC;
Projects
for Youth
Joint
projects
to reduce
retinopat
hy
Center of
dialysis
More
attention
for
patients
initiative
(Doctors
in DA do
not allow
patients
to
be
active).
It must be
discussed
on IDF/E
level
Direct
contacts
from IDF/E
to
Governmen
t of country
(through
EP
or
IPA);
Twinning
programme
with
stronger
Association
s;
Training
courses for
chairs
of
NDA
IDF
informatio
n
in
Russian
Improvem
ent
of
interplay
in Board
Russian Diabetes Federation
Moscow
DA
Russian DA
All
Russian
DA
IDF
informatio
n
in
Russian;
Create
system of
competitio
ns
for
projects
(national,
regional,
internation
al level) for
improving
life
of
patients.
Open
discussions
on projects
with
all
members
of IDF/E;
Financial
support for
projects
Improve
work
with
NDA
from
EEC
Representativ
e in IDF/E
board from
EEC
for
coordination
of activities of
Associations
from CIS
Now
IDF/E
works
only for
interests
of
pharmace
utical
companie
s
St.
Petersb
urg DA
See Q.
No 2
I. Development
1. Organizing activities Diabetes Associations have the same
problems in most countries. They have mentioned these
problems:
• Financial (Georgia, Russia, Belarus, Kazakhstan)
• Bureaucracy of governmental sector (Azerbaijan, Russia)
• Low activity and exploitative position of patients
(Kazakhstan, Russia, Kirghizstan)
• Non-existence of Law for NGO (Ukraine)
• Interference for NGO activity from side of Government
(Russia)
• Incomprehension of society the role of patients organizations
(Russia)
• Lack of relation among sectors of society, difficulties for
NGO to solve social problems (Russia)
• Passivity of National Diabetes Associations, formalism of
activity (Russia)
• Lack of coordination among Diabetes Organizations
(Azerbaijan)
• Conservatism of health professionals (Russia)
I. Development
2. Diabetes Associations would like to get from IDF/Europe such
support:
•
•
•
•
•
•
•
•
More round table discussions, sessions in countries (Azerbaijan)
Financial, Grants for National projects (Belarus, Russia, Georgia,
Ukraine, Kazakhstan)
Information in Russian (Kazakhstan, Ukraine, Russia,
Kirghizstan)
Representative from Council of experts of IPA of CIS must be in
IDF/E Board (Russia)
Training courses for representatives of NDA about development
of organizations (Russia)
Policy (Georgia)
Institution (Kazakhstan)
Methodical (Ukraine)
I. Development
3. Suggestions to IDF/Europe Board for better cooperation with diabetes
associations of EEC:
•
•
•
•
•
•
•
•
•
•
•
•
•
More support to EEC (Azerbaijan, Russia)
Prolongation of Annual Meetings of EEC (Belarus)
Projects for Youth (Belarus)
Joint projects to reduce retinopathy. Center of dialysis (Georgia)
More attention for patients initiative (Doctors in DA do not allow patients
to be active). It must be discussed on IDF/E level (Kazakhstan)
Direct contacts from IDF/E to Government of country through EP or IPA
of CIS (Kirghizstan)
Twinning programme with stronger Associations (Kirghizstan)
Training courses for chairs of NDA (Kirghizstan)
IDF information in Russian (Ukraine, Russia)
Improvement of interplay in Board (Ukraine)
Create system of competitions for projects (national, regional,
international level) for improving life of patients. Open discussions on
projects with all members of IDF/E (Russia)
Improve work with NDA from EEC. Representative in IDF/E board from
EEC for coordination of activities of Associations from CIS (Russia)
Now IDF/E works only for interests of pharmaceutical companies (All
Russian DA)
What is real situation on social, societal aspects
and patients’ rights in the 7 Eastern European
Countries?
II. General information and policy framework
S
.
N
.
Situation in
country
Azerbaijan
DA
Belarussi
an
HO
Georgia
n
DU
Kazakhstan
DA
Kirghizstan
DA
Ukrain
ian
DF
+
+
+
+
Programme
,,Diabetes”
was
implementin
g 2000 –
2003.
Now
practically
implementat
ion of plan
on diabetes
is organized
by law.
No
Programme
was
prepared by
endocrinolog
ists
and
coordinated
with
all
institutions
but was not
approved by
government
because of
lack
of
finance
+
1
.
IDF member
+
+
2
.
National
Diabetes Plan
+
Law
on
diabetes is
approved
,,Diabetes
”
is
included
in
the
State
program
me
,,Health
of
Nation”
Cabinet
Council
and
Ministry
of Health
administr
ate
Plan,
named
NDP
Russian Diabetes Federation
Moscow DA
(MDA)
Russia
n DA
All Russian
DA
St.
Pete
rsbu
rg
DA
+
Since
1994
programm
,,Medical support
for people with
diabetes”
was
prepared
by
initiative
of
MDA
and
implemented in
Moscow.
Since
1996
Federal
Programme
of
Russia
,,Diabetes”
is
implementing.
Since
1996
Federal
programme
,,Diabetes”.
Lack
of
money.
Progr
amm
Diabe
tes
Program
m
Diabete
s
is
prepare
d.
It must
be
confirm
ed
by
Duma
(Counci
l)
II.General information and policy
framework (continue)
S
.
N
.
Situation in
country
Azerbaija
n
DA
Belarussi
an
HO
Georgia
n
DU
Kazakhstan
DA
3
.
Equal partner
4
.
5
.
Kirghizstan
DA
Ukrai
nian
DF
+
No
No
+
No
+
Newspaper
(magazine)
Metaboliz
m
In World
of
Diabetes
No
Diabete
s and
Health
Dialog
No
Home page
No
No
www.di
abet.ge
www.dark.
os.kz
gedskm@m
ail.ru
Russian Diabetes Federation
Moscow DA
(MDA)
Russia
n DA
All Russian
DA
St.
Pete
rsbu
rg
DA
+
No
No
Difficul
t
Diabet
es and
Life
MDA has not a
newspaper.
MDA has close
contacts
with
editors
of
Diabetes
–
Lifestyle
and
DiaNovosti
Vestnik RDA
Diabe
tes
news
paper
of
Russi
a
and
regio
nal
issues
Diabete
s
Newspa
per of
St.
Petersb
urg DA
+
+
www.rda.org.
ru
www.
diabe
tes.
org.r
u
diacent
r@mail.
wplus.n
et
II. General information and policy
framework
•
•
•
•
National Diabetes Plan
•
•
•
•
Law on diabetes is approved in Azerbaijan, Kazakhstan.
Diabetes is included in the State Health programme in Belarus.
Russia has Federal Programme of Diabetes.
Georgia has plan, named National Diabetes Plan.
Equal partner
Diabetes organizations are recognized as equal partner in making
healthcare decisions in the State institutions in Azerbaijan,
Kazakhstan, Ukraine, Russia (only in Moscow).
Newspaper
Diabetes organizations in most countries (Azerbaijan, Georgia,
Kazakhstan, Ukraine, Russia) publish the newspaper or journal.
Website
Diabetes organizations in Georgia, Kazakhstan, Ukraine, Russia
have home page on website.
What is real situation on social, societal aspects and
patients’ rights in the 7 Eastern European Countries?
III. Reimbursement III.1. Medicine
S
.
N
.
Name of medicine,
reimbursement (%),
remarks
1.
Animal insulin
2.
Human insulin
Azerbaij
an
DA
Belarus
sian
HO
Georgia
n
DU
Kazakh
stan
DA
Kirghizst
an
DA
Ukrainian
DF
Russian Diabetes Federation
Moscow
DA
100%
Type 2
100%
short
accessabili
ty
of
medicine;
extra pay
for
patients
100%
Type 1
Russian DA
All
Russ
ian
DA
St.
Petersb
urg
DA
100%
Government
100%
100%
Governm
ent
+
centralist
purchase
100%
Government
100%
Intraurban
budget Moscow
(86% penfil)
100%
100%
Gover
nment
Governm
ent
pay
for
disabled
people
100%
governm
ent
in St
Petersbu
rg
III. Reimbursement
III.1. Reimbursement of medicine
•
Government compensates 100% for human insulin
in all countries with restrictions in Azerbaijan (short
accessability of medicine, extra pay for patients),
Belarus (only for Type 1), Russia (only for disabled
people, except Moscow and St Petersburg), and
analogues insulin the same.
•
In Kirghizstan is organized centralist purchase of
medicine, analogues insulin are compensated only
for children.
III. Reimbursement III.1. Medicine (continue)
Name of medicine,
reimbursement (%),
remarks
S.N.
4.
Oral medicines
5.
Glucagon
6.
Insulin pumps and pump
accessories
7.
Pens
8.
Syringes
8.
Other medicines
Azerbaija
n
DA
Belarussi
an
HO
Georgian
DU
Kazakhst
an
DA
Kirghizstan
DA
Ukrainian
DF
100%
short
accessabilit
y of
medicine;
extra pay
for patients
100%
extra pay
for
patients
Supply
from
local budget
~50%
100%
short
accessability
of medicine
from
regional
budget;
extra pay for
patients
No
Reimbursement
(100 18%)
Russian Diabetes Federation
Moscow
DA
100%
Intraurban budget
of Moscow
100%
+
100%
+
Russian DA
All
Russi
an
DA
100%
100%
extra
pay
for
patient
s for
new
medici
ne
Governme
nt
pay
for
disabled
people
St.
Petersbu
rg
DA
III. Reimbursement
III.1. Reimbursement of medicine
•
Government compensates 100% for oral medicine in most countries with
restrictions. Short accessability of medicine and extra pay for patients are
in Azerbaijan, Kirghizstan. Oral medicine are not reimbursed in Georgia
and Ukraine.
•
Accessability of medicine depends from local budget in Kirghizstan,
Kazakhstan, Russia.
•
Animal insulin is used only in Belarus and Ukraine (100% compensation).
•
The Government do not compensate Glucagon, Insulin pump in any
country.
•
Compensation of 100% of pens and syringes is mentioned in questionnaire
only in Kirghizstan and Russia (only in Moscow).
•
No countries mention compensation of other medicine for people with
diabetes in their answers to the questionnaire.
What is real situation on social, societal aspects and
patients’ rights in the 7 Eastern European Countries?
What is real situation on social, societal aspects and
patients’ rightsin the 7 Eastern European Countries?
III. Reimbursement
S.N.
For people with T1
and T2 Diabetes,
reimbursement
%
and number of strips
per year
Azerbaijan
DA
1.
Type 1
1.1
Children
1.2
Adult
No
1.3
Pregnant woman
No
Belarussi
an
HO
Georgian
DU
Under 18
year only
1
strip/day
100%
All strips for
year
Kazakhstan
DA
Kirghizstan
DA
III.2. Monitoring strips
Ukrainian
DF
Russian Diabetes Federation
Moscow DA
Russian DA
All
Russi
an
DA
No
300
strips/year
No
4 strips/day
(supply from
KDA)
Since 2004 free
glucometers
from funds of
Germany
800 ( + 100 for
acetone)
By medical indications
can be reimbursed
extra strips
From regional budget.
In different regions
400 – 1200 strips/year
No
400
( + 100 for acetone)
0 – 600 strips/year
No
By medical indications
in time pregnancy + 3
month after
pregnancy
200
strips/year
Till
now
it
depen
ds
from
region
al
budge
t.Bette
r
situati
on is
in big
towns
III. Reimbursement
III.2. Monitoring strips
(continue)
S
.
N
.
For people with
T1
and
T2
Diabetes,
reimbursement
% and number
of strips per year
Azerbaija
n
DA
Belarus
sian
HO
Georgian
DU
2
.
Type 2
No
2
.
1
Children
No
2
.
2
Adult
No
2
.
3
Pregnant
woman
No
By medical
indications
in time
pregnancy
+ 3 month
after
pregnancy
Remark:
now is not
reimburse
ment for
strips,
but it is
covered in
the NDP
By medical
indications
for people
with
nephropath
y
No
Kazakhst
an
DA
Kirghizstan
DA
Ukrainian
DF
Russian Diabetes Federation
Moscow DA
400 (with
insulin)
200 (with
oral
medicine)
Russian DA
All
Rus
sian
DA
St. Petersburg DA
50 visual strips/month (with
insulin)
III.2. Reimbursement of
Monitoring strips
•
Government compensates 100% different number of strips in
different countries.
•
•
•
In most countries strips are compensated only for children.
•
•
In Kazakhstan - 300 strips/year.
•
•
Best situation is in St Petersburg, Russia (100 strips/month).
In Moscow 800 strips/year (+ 100 for acetone), by medical
indications extra strips can be reimbursed.
In Russia compensation depends from regional budget. In
different regions 400 – 1200 strips/year for children. Better
situation is in big towns.
In Georgia - 100% of all strips for year.
Ukraine - 200 strips/year.
III.2. Reimbursement of
Monitoring strips
•
Monitoring strips are not reimbursed even for children in
Azerbaijan, Belarus and Kirghizstan.
•
Monitoring strips for adults with diabetes are reimbursed only in
Moscow {400 strips/year ( + 100 strips for acetone)} and St
Petersburg (50 visual strips/month for people treated with
insulin).
•
In Russia (0 – 600 strips/year), compensation depends from
regional budget.
•
In Moscow pregnant women get free strips by medical indications
in time pregnancy + 3 month after pregnancy. By medical
indications for people with nephropathy strips are free too.
Reimbursement of HbA1c
No country mentioned
reimbursement of HbA1c.
What is real situation on social, societal aspects and patients’ rights in
the 7 Eastern European Countries?
IV. Do children and adolescents have the same social rights as their
non-diabetic fellows?
S
.
N
.
Social rights
1
.
Azerbai
jan
DA
Belarussian
HO
Georgian
DU
Kazakhsta
n
DA
Kirghizst
an
DA
Ukrainian
DF
Education and
opportunities to
participate in
different types of
school activities
(such a camps,
trips, and sports
activities)
+
+
+
+
+
2
Take part in
physical activities
during leisure time
+
+
+
+
3
A free choice of
profession (with
some few necessary
restrictions)
+
+
+
+
4
Reasonable
insurance rates
5
Can parents get the
necessary economic
support to give
their child
adequate treatment
Russian Diabetes Federation
Moscow
DA
Russian
DA
+
Sometimes
+
+
+
No
+
+
officially
+
+
No
+
+
officially
All Russian DA
+
officially
No
Support
from
government
is skimpy
No
Remark: in
real situation is
discrimination
IV. Children and adolescents rights
•
Children and adolescents have the same social rights as their nondiabetic fellows to:
1. Education and opportunities to participate in different types
of school activities (such a camps, trips, and sports activities)
– in all 7 countries. Some discrimination occurs in Russia.
2. Take part in physical activities during leisure time – in all 7
countries. Some discrimination occurs in Russia.
3. A free choice of profession (with a few necessary restrictions)
– in 7 countries. In Russia there is discrimination. Children
conceal their disease.
4. Reasonable insurance rates – answer NO in Moscow.
• Can parents get the necessary economic support to give their child
adequate treatment?
• Answer NO - in Moscow.
• Support from government is skimpy in Belarus.
• In real situation is discrimination in Russia.
V. Do people with diabetes have routinely free
access
S
.
N
.
Access to:
(Remarks)
Azerbaijan
DA
Belaruss
ian
HO
1
.
Diabetes
education
In ADA
organizatio
ns
+
2
Foot care
3
Endocrinologist
4
Oculist
5
Georgian
DU
+
+
+
+
+
+
+
+
Dietitian
+
Psychologist
Other health
professionals
…cardiologist…
…………………
…………………
…
…………………
……
+
Kazakhsta
n
DA
Kirghizs
tan
DA
Ukrainian
DF
Only for
cityzenri
of
capital
of
country
No
Russian Diabetes Federation
Moscow DA
Russian DA
All Russian
DA
+
Inaccessible
in most
regions
No
No
+
+
No
No
+
+
No
No
+
+
No
No
+
+
+
No
No
+
+
+
(only lack
of new
equipment
)
No
Restriction
s for people
from back
country for
education
and
specialists
No
Lack of
professionals
Doctors have
3 times more
patients than
by
standards.
Difficulties
for people from
back
country
Low quality of
medical services
Lack of
various
specialists.
Low
quality of
medical
services.
Better
situation
+
Lack of
professionals
Low salary
of doctors
Low quality
of medical
services
Tight finance
for services
V. Do people with diabetes have
routinely free access to:
1. Diabetes education
- YES in Azerbaijan (only in DA organizations), - Kirghizstan (only for cityzenri of capital of country ),
- Belarus and Russia.
2. Foot care – YES in Belarus, Georgia and Russia.
3. Endocrinologist and Oculist – YES in Azerbaijan, Belarus,
Georgia, Kirghizstan, Russia.
4. Dietitian and Psychologist – Yes in Belarus, Georgia and
Russia.
V. Do people with diabetes have
routinely free access to:
• Lack of various specialists, better situation in big
towns is mentioned in questionnaire of
Kazakhstan,
• Russia (doctors have 3 times more patients than
by standards in Moscow), Ukraine;
• Only lack of new equipment (Georgia);
• Difficulties for people from back country
(Ukraine, Russia);
• Low quality of medical services (Kazakhstan,
Russia).
VI. Do people with diabetes have unreasonable
restrictions, ignorance, prejudice? Other Concerns.
S
.
N
.
Restrictions to:
(remarks)
Azerbaij
an
DA
Belarussi
an
HO
Georgi
an
DU
Kazakhst
an
DA
Kirghizst
an
DA
Ukraini
an
DF
1
.
Drivers’ licence
No
No
No
No
No
+
2
Employment
No
+
No
+
People
conceal
their
disease
No
3
Insurance:
▬ Life insurance
▬ Health
insurance
No
+
+
+
+
No
No
Russian Diabetes Federation
Moscow
DA
Russian
DA
All
Russian
DA
St.
Petersbur
g DA
With
permission
of doctor
+
Discrimina
tion
People
conceal
their
disease
+
+
Sometimes
+
People
conceal
their
disease
Discrimina
tion
People
conceal
their
disease
People
conceal
their
disease
+
+
+ Private
+ Private
+
Only
compulsor
y
insurance
is for all
people
System of
insurance
is not
developed
VI. Do people with diabetes have unreasonable
restrictions, ignorance, prejudice? Other Concerns.
(continue)
S
.
N
.
Restrictions to:
(remarks)
4
.
Other concerns
Azerbaija
n
DA
Restrictio
ns
for
professio
nal
drivers
Belarussi
an
HO
Georgia
n
DU
Kazakhsta
n
DA
Kirghizst
an
DA
Low
pension
s;
Lack of
pension
s
for
elderly;
Lack of
reimbu
rsement
for
medicin
e
Kazakhstan DA
Dependence of patients
from doctors;
Malpractice of doctors;
Non-existence
of
diabetes, rehabilitation
centers;
Low salary of doctors,
lack of specialists, low
living
standards
of
patients;
Low
quality
of
education of specialists;
Financial
disbalance
among regions;
Inefficient partnership
among medical sectors;
Played out technical
basis
of
medical
equipments
Ukrainia
n
DF
Russian Diabetes Federation
Moscow
DA
Russian DA
All Russian
DA
St.
Petersbur
g DA
Remark of Moscow DA:
Responsibilities
of
governmental bodies for
support of people with
chronic diseases are revised
by Federal law of Russia.
People with invalidity get
support
from
Federal
Budget,
other
from
regional.
Support
is
different in regions. In
Moscow all people get
equal support by law of
Health Department of
Moscow.
Remark of RDA:
Patients do not know their
rights.
RDA
has
established
centers
of
social
psychological
rehabilitation.
We wish to
IDF/E
Board to
negotiate
conformanc
e
Lack of
specialists
Difficultie
s to get
efficient
medical
services
VI. Do people with diabetes have
unreasonable restrictions, ignorance,
prejudice to:
1.
Drivers’ licence – YES in Ukraine, Russia. People conceal
their disease.
2.
Employment – YES in Belarus, Kazakhstan, Ukraine,
Russia. People conceal their disease.
3.
Life Insurance – NO only in Azerbaijan, Kirghizstan.
4.
Health Insurance – NO only in Azerbaijan, Kirghizstan.
In Russia only compulsory insurance is for all people.
System of insurance is not developed in Russia.
Other comments on social, societal
aspects and patients’ rights were
mentioned in questionnaire.
•
Restrictions for professional drivers in Azerbaijan.
•
Low pensions; Lack of pensions for elderly; Lack of
reimbursement for medicine in Georgia.
•
Dependence of patients from doctors; Malpractice of
doctors; Non-existence of diabetes, rehabilitation centers;
Low salary of doctors, lack of specialists, low living
standards of patients; Low quality of education of
specialists; Financial disbalance among regions; Inefficient
partnership among medical sectors; Played out technical
basis of medical equipments in Kazakhstan.
Other comments on social, societal
aspects and patients’ rights were
mentioned in questionnaire.
• Federal law of Russia revises responsibilities of
governmental bodies to support of people with chronic
diseases. People with disabilities get support from Federal
Budget, other from regional. Support is different in regions.
In Moscow all people get equal support by law of Health
Department of Moscow. Patients do not know their rights.
RDA has established centers of social psychological
rehabilitation.
• Lack of specialists; Difficulties to get efficient medical
services in St Petersburg.
Conclusions
I hope that this brief survey will help
IDF/Europe Board to have more
information on the real situation on
Associations development, social, societal
aspects and patients’ rights in 7 Eastern
European Countries.
Conclusions
In my opinion IDF/Europe Board has to
hear problems, mentioned in this paper,
and to give more attention to region of
Eastern European Countries in the
nearest future.
©Vida Augustiniene, Lithuanian Diabetes Association