Type 2 diabetes constitutes an emerging health problem in Burundi. However, after 10 years of civil war, the condition of Burundi's health care system is among the poorest in the world.

As a result, while diabetes represents the third leading cause of hospitalisation, standard medical resources and personnel trained in diabetes care are often nonexistent in the country. 

Moreover, the population lacks awareness of early symptoms of diabetes. Consequently, the condition is usually not diagnosed until the onset of acute and/or chronic complications such as amputation of limbs, kidney failure or loss of sight. 

Approach

The project is a multi-partner intervention. Implementation is lead by APSA International in collaboration with the organisation Diabète au Logis, which coordinates training and provides scientific support and expertise in education and training matters. Other partners involved include the diabetes associations ALUDIA and APREPRIDA, the private clinic CELUCODIA and the NGOs Handicap International and GVC - Groupe De Volontariat Civil.

In total, diabetes care capacity will be strengthened in 23 health centres, which prior to the project did not offer diabetes care. 

Initially, a database is established to enable registration of patients, professionals, structures and partner centres. One purpose of this is to obtain better knowledge of the prevalence of diabetes in Burundi.

A total of 30 community diabetes educators will be trained to deliver health education and promotion sessions in the communities.

The health education session will initially be carried out in the urban area of Bujumbura. The trained educators will each lead a weekly group session with participation of around 6 people with or at-risk of diabetes. Focus will be on management of diabetes, cardiovascular risk, diet and physical activity with an emphasis on the social and cultural contexts of the target groups.

Participants are identified through a detection and screening programme. It is expected that 3,000 people will be screened each year and out of these 1,000 will participate in the health education sessions.

In parallel, 60 doctors and 60 nurses from government health care facilities and NGOs will undertake a 3-day training course on provision of basic diabetes care. Training includes awareness of diabetes, early symptoms, long term as well as short term complications and treatment.

Upon completion of the training, the doctors and nurses will function as reference contacts in their respective health care facilities and will also be able to conduct screening for diabetes.