The project aims at improving health care capacity to deliver qualified care to children with diabetes and other endocrine diseases in Sub-Saharan Africa.
Expected impact
36 paediatricians from five African countries undergo a specialised 15 months training programme
1,500 children with diabetes diagnosed and receiving treatment
Establishment of paediatric diabetes clinics in five African countries
Results to date
The programme has conducted 5 rounds of training (18 months' duration each) reaching a total of 27 paediatric fellows from (the fourth and fifth rounds are still running).
1,004 children with diabetes have been registered, diagnosed, treated and followed up upon at the Nairobi-based paediatric clinics set up under the programme (Gertrude's Children's Hospital (GCH), Aga Khan University Hospital (AKUH), and Kenyatta National Hospital (KNH)).
17 diabetes clinics have been established and 5 strengthened in the participant's home countries. 1,195 children with T1DM have been treated at these clinics.
73 doctors, 113 nurses and 12 paramedics have been trained in T1DM management through outreach training activities (Nyeri, Kijabe Hospital).
8 camps have been held reaching 195 people and screening 60 children.
The trained paediatric fellows have formed the first The African Society for Paediatric and Adolescent Endocrinology (ASPAE) which was launched in June 2010.
Project details
In Africa most children with diabetes die undiagnosed during their first attack of diabetic ketoacidosis.
Children who are diagnosed often do not receive qualified and sufficient treatment at the hospital and subsequently die because the family cannot afford long-term medication.
In addition, tertiary facilities and trained personnel for paediatric diabetes and other endocrine diseases are virtually non-existent. Therefore, there is a need to put in place programmes addressing the two key barriers to care for children with diabetes in Africa: capacity building and access to treatment.
Approach
The project is implemented through collaboration between University of Nairobi, Aga Khan University Hospital and Gertrude's Children's Hospital. In addition, the European Society for Paediatric Endocrinology serves as faculty/mentors.
Training of African paediatricians in recognising and treating diabetes and other endocrine conditions will be conducted through a 15-months fellowship programme.
The fellowship programme includes 6 months of training at the collaborating institutions' clinics, 6 months of practice at the home institution and 3 months of consolidation in Nairobi.
The training comprises an educational programme targeting both the professional and the public. It includes basic skills in the identification of readily diagnosable endocrine conditions with an emphasis on diabetes; clinical data collection and surveillance to ascertain best practice and basic principles of care for children with diabetes.
An expected number of 12 fellows are to be trained each year.
For a period of 1-2 months, tutors from the European Society for Paediatric Endocrinology will provide relevant on-site clinical and laboratory training as well as programme supervision.
Initially, three permanent faculty members from the three programme institutions will be part of the fellows trained in the first year. The three faculty members will then continue the fellowship programme until the end of implementation.
The criteria for eligibility for the programme are that the fellow is a fully trained paediatrician and that 75% of the fellows are from the public sector.
Upon completion of the fellowship, the fellows are obliged to return to their home settings to implement their new skills and establish paediatric diabetes/endocrine clinics within their host institutions.
Comprehensive paediatric and endocrinology clinics will be set up in Kenya, Nigeria, Tanzania, Ethiopia and Uganda.
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