HEALTH SYSTEMS BARRIERS AND FACILITATORS TO TYPE 2 DIABETES PREVENTION AND CARE IN SINGAPORE AND LONDON: A COMPARATIVE QUALITATIVE STUDY

Abstract

The global burden of Type 2 Diabetes is rising, driven by population ageing, sedentary lifestyles, obesity/overweight, and social determinants of health. Health systems play a crucial role in responding to T2D. Singapore and London are diverse, high-income metropolises with similar T2D challenges but differing health systems and health system responses to T2D. This thesis aimed to assess the evidence for health system barriers and facilitators of T2D prevention and care, identify and compare Singapore and London’s barriers and facilitators of T2D prevention and care, and raise policy and research implications to inform T2D prevention and care across settings. We conducted a systematic review of system-level factors influencing aspects of T2D, a literature review of health systems frameworks, and in-depth interviews with patients, healthcare professionals, and policymakers. Findings point to complex health system and non-health system challenges across settings and stakeholder groups that shape health systems responses to T2D.