In Tunisia, diabetes is a severe health challenge. Over 704,400 cases of diabetes were diagnosed in 2013 (IDF, 2014), with a 9.3% prevalence rate among adults. This is in addition to a high estimated number of undiagnosed cases: around 80% of diabetes on the continent is estimated to go undiagnosed at present. Even for those who are aware of their disease condition, there are additional challenges to the management of secondary conditions and diabetes-related complications such as renal failure, blindness and diabetic foot.
To reduce premature deaths resulting from diabetes, by improving health system access and resources. outcomes include: enhanced market and use of mobile technology in health services; a decrease in government health expenditure due to a healthier populations; increased numbers of health workers trained in diagnosis of diabetes and related complications such as diabetic foot;
• Establishing of national project steering committee in Tunesia chaired by the MoH/National Diabetes Programme coordinator and to include national level stakeholders and ITU/WHO representatives.
• Preparation of mobile phone applicable e-learning/text message (SMS) based material with diabetes tuition for HCPs and with patient education and awareness material; To be based on existing material developed by ITU and WHO from a similar programme in Senegal; French language version to be adapted to local Tunesian conditions and a local dialect arabic version also to be prepared.
• Roll out of the three parallel components of the diabetes mHealth programme, including i) training of HCPs notably at primary level and also targeting remotely located clinics, with training to combine e-learning with face-to-face training; ii) patient education with focus on self-management of diabetes, reminders concerning care and glucose control, diet etc., and, iii) general awareness raising through SMS based services accessible to various population segments. For each component an initial pilot phase will apply before larger scale roll out; For components ii) and iii) various enrolment promotion activities would be launched.
• The programme roll out would be partially based on a current mHealth programme in Tunesia on tobacco cessation.
• 500 HCPs from rural and urban primary clinics to have been enrolled into the mobile based e-learning platform and to have been trained in basic diabetes care and prevention
• 35,000 known cases of diabetes to have been enrolled into the mobile phone based patient education platform
• At least 35,000 people to have accesssed the general awareness mobile phone based services at different levels
• Tunesia MoH and the project steering committee to have applied a comprehensive monitoring framework co-developed with ITU and WHO including a range of clinical as well as process related impact indicators