The project aims at reducing morbidity, development of complications and mortality due to diabetes.
Expected impact
516 health care professionals trained on prevention and management of diabetes
40 physiotherapists and foot therapists trained
7 foot care teams trained on Step-by-Step model
75,000 people with diabetes benefiting from improved quality of care
Sensitisation of the general public through awareness activities focusing on prevention of diabetes
Results at project completion
256 doctors, 123 nurses and 155 paramedics in all six municipalities of Bamako have been trained in primary level diabetes care.
11 surgeons and 30 physiotherapists have been trained.
One diabetic foot clinic has been established at the main referral hospital Point G in Bamako.
As a result of the consultation and education set up in the health facilities, the level of knowledge among a cohort of patients has increased; HbA1c values have been reduced (from 8.46 to 7.8); and a reduction of waist circumference has been seen among men and women.
All Step-by-Step material which includes two Step-by-Step booklets, posters and two movies have been translated into French and adapted. All diabetes units have been equipped with a prevention kit and of care for diabetic foot.
Awareness: Five broadcastings were made in public and private radio stations in Mali. Two programs were shown on the Malian national television channel.
87,816 people in Sikasso, Timbuktu and Bamako have been reached by a six-months peer education programme.
Five new diabetes patient associations have been created in the districts of Segou, Kayes, Mopti, Douentza and Timbuktu.
Project details
In Mali, 1 year of insulin purchase levies 38% on family incomes, thus cost of diabetes and its complications is a major poverty factor and excludes underprivileged populations from health care.
Santé Diabète Mali has changed diabetes care in the country since 2004, but with a prevalence of diabetes exceeding 3% and a population not receiving proper health care, it is necessary to scale up diabetes prevention and care.
In addition, the Step-by-Step foot care model developed under WDF03-056 will be used to improve capacity for preventing and treating the diabetic foot.
The project will be implemented in the Bamako and Douentza districts and in Timbuktu, Sikasso, Mopti, Gao and Kayes regions.
The project is co-funded by the European Commission and the Swiss Development Co-operation. Handicap International collaborates with Santé Diabète Mali on the foot care component.
The target groups are: General population, people with diabetes and their families as well as health care professionals. The aim is to promote an overall approach to diabetes, which places people living with or at-risk of diabetes in the centre.
The project has 3 main components:
Consolidation of the diabetes care delivery system
Information, education and communication (IEC) for the population to reinforce diabetes prevention
Establishment of prevention and management capacities of the diabetic foot
The first component aims at continuing the model of decentralisation of diabetes care delivery established in Mali with training of health care professionals. Equipment for analysis and educational materials will be provided and patient associations will be strengthened.
The activities carried out under this component include continuing decentralisation of care at secondary and primary care level, initiating decentralisation at tertiary level and supporting the establishment of an Endocrinology & Diabetes Unit.
In addition, it comprises several training courses aimed at health care professionals working in the participating regions and at different levels within the health care system. In total, 516 health care professionals will be trained on diabetes prevention and care.
Moreover, 1000 students from health care schools will receive specific training on diabetes prevention and care to ensure they have some knowledge of diabetes when they graduate.
The second component focuses on sensitising, informing and promoting changes in the behaviour of general public in order to prevent diabetes.
Activities under this component include IEC sessions performed by peer educators, adaptation and re-designing of the education and information toolkit developed under WDF04-074, dissemination of messages concerning diabetes through the media, organisation of screening days in the target areas and, eventually transfer of the responsibility of the IEC sessions to the patient associations.
The third component aims at improving prevention and management of the diabetic foot in the 4 areas of Bamako and Douentza districts as well as Sikasso and Timbuktu regions using the Step-by-Step model.
The Step-by-Step model seeks to provide a strategy for preventing and managing the diabetic foot by improving health care professional capacity for managing the diabetic foot and increasing patient knowledge of self-care for their feet.
The activities conducted under the third component involve adaptation of the Step-by-Step tools and translating them into French, establishment of a diabetic foot unit within the Endocrinology & Diabetes Unit, basic and advanced training courses for 7 teams of health care professionals to provide prevention, care and education on the diabetic foot as well as training of surgeons, physiotherapists and foot therapists regarding surgery on a patient with diabetes and the particularity of a diabetic amputation, which will be fitted with a prosthesis.
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