Liberia is one of the least developed countries in the world. The West African country has a population of 4,5 million people, and the diabetes prevalence in adults is estimated to be 5,6%.
Poverty and a poor diet, such as high carbohydrate intake from staple foods, are often linked, and this can explain why overweight is common in Liberia, leading to a higher risk of developing diabetes and complications.
Of all Liberian adults, 22,5% are overweight and 5,8% are obese, according to WHO. The difference in gender is striking: one in three women are overweight (29,5%) and one in ten is obese (9,2%).
The majority of the 225,000 people in the Ganta catchment area, the target of this project, live in remote and rural communities with very limited access to any health care. Chronic illnesses, such as diabetes, are usually not recognised or treated resulting in premature death and/or serious long-term complications.
The goal is to reduce mortality and morbidity caused by complications of diabetes such as peripheral neuropathy. This will be achieved by improving or enhancing community outreach and facility-based services with screening, education, and treatment protocols that include medication and foot care.
A diabetes outreach programme will be established in 15 rural communities within the Ganta Hospital catchment area by training and supporting general Diabetes Community Health Volunteers (gDCHV). They will, like the general Ganta Hospital health care staff, be provided with basic diabetes education training.
Specialised training will be given to Ganta Hospital Diabetes Specialists for management of diabetes, and to Foot Care Specialists to address diabetic foot care.
At monthly camps, screening clinics and various educational strategies such as dramas and lectures will take place to increase the awareness of diabetes throughout the city and surrounding villages.
Diabetic foot care will be addressed through screenings, treatment, and education.
Finally, a reporting and recording system will be established to provide accurate prevalence data to support a national strategy.
- 15 community health volunteers provided with training in basic diabetes care and counselling
- 25 community health workers trained as Trainers of Trainers (ToTs).
- 116 hospital and 15 primary clinic medical staff trained in complications management with a special focus on diabetic foot care
- 150,000 people sensitised about diabetes
- 250 awareness and screening camps held
- 7,200 people screened for diabetes
- 3,000 patients screened for foot ulcers and approximately 400 provided specialised foot care
- Prevalence data recorded and presented to MoH
Results at completion:
• 15 Diabetes Community Health Volunteers (DCHVs) trained, supervised and empowered
• 199 healthcare workers (doctors, nurses, physician assistants, midwives and nurse aides) trained to provide diabetes care and to supervise diabetes community health volunteers
• Diabetes treatment protocols developed and distributed in 25 healthcare facilities in Nimba county
• 174,980 residents reached through awareness
• 732 awareness and screening activities completed
• 39,145 people screened for T2DM (prevalence data recorded and shared with MoH)
• 3,843 people screened for diabetic foot problems; 278 patients with diabetic foot problems referred for treatment
• 63 radio shows conducted