Diabetes clinics

Diabetes with its complications is one of the most important non-communicable diseases in Tanzania.

A 1997 study indicated a diabetes prevalence of close to 6% in Dar es Salaam. The prevalence rate for Tanzania is estimated at 2.3%.

As in the rest of Africa, this rate is expected to increase in the coming years.

At present, diabetes is managed in only a few locations. The necessary infrastructure in terms of trained manpower, equipment and drugs is not available at most levels. As a result, a large number of diabetes patients remain unattended. Those who do receive treatment, often receive poor and inadequate treatment.

Late diagnosis of diabetes is a common problem in Tanzania - among others due to low awareness of diabetes among health personnel and the public. Therefore, the rate of diabetic complications is high.

Objective

The project aims to improve access to and raise the quality of diabetes care in Tanzania.

Approach

Initially 4 regional hospitals where diabetes services are non-existent will be supported by the project. These are:

• Mtwara - Southern part of Tanzania
• Rukwa - South Western part of Tanzania
• Kigoma - Western part of Tanzania
• Musoma - Northern part of Tanzania

After establishment of clinics at the regional level, the project aims for similar clinics to be established at district level.

Training of health care providers is a central element of the project. This will help improve the availablity and quality of diabetes care in Tanzania. Training workshops are conducted focusing on prevention and control of diabetes and its complications.

The trainees will also be asked to complete the treatment manuals to be used in their work. Active participation in the development of manuals and guidelines increases the level of their subsequent use. 

Upon completion of training, each member of the regional personnel will be provided with a start-up kit containing the essential equipment and drugs for diabetes care. They will return to their regional hospitals and start the clinics. The aim is to ensure minimum standards of care.

Free treatment will be provided to those unable to pay from revenue generated by paying patients.

The overall goal is to establish diabetes clinics at each of the 20 regional hospitals in Tanzania as well as provide district clinics to the exten possible. This will facilitate access to diabetes care for the majority of the population.

The initial goal of 20 regional clinics has been realised through fundraising activities conducted by World Diabetes Foundation. To date funds are available for 19 additional clinics, bringing the total to 23 clinics. In addition, outside of this project, the Venice Diabetes Association supports additionally 5 clinics. This has allowed for 8 district clinics.

The local branch of the Tanzania Diabetes Association will be involved and established where none exists. This allows interaction with the diabetes clinic, people with diabetes and the general public.

Expected impact

• 4 diabetes clinics established by the project at regional hospitals in Mtwara/Lindi, Ruhwa, Kigoma and Musoma
• 19 additional diabetes clinics established through fundraising by the Foundation
• Access to diabetes care facilitated
• Quality of diabetes care improved
• Short term complications prevented
• Long term complications prevented or delayed

Results at project completion

• 23 diabetes clinics have been established: 4 directly under this project and 19 through WDF fundraising (WDF-F03-002).
• 23 doctors/clinical officers, 46 nurses and 23 laboratory technicians have been trained.
• 39 additional TDA (Tanzanian Diabetes Association) branches have been established in the project supported clinics.
• More than 9,000 people with diabetes are seen at the clinics annually.
• 360 education sessions have been held locally by the clinics.
• Handouts for patient have been produced. TDA is working on creating a consensus diabetes education manual.