Objectives & Approach

The health situation in Zimbabwe is recovering after an unprecedented decline during the first decade of this millennium. The deterioration of the infrastructure, lack of investment, poor remuneration of health care workers and shortage of essential supplies led to the near-collapse of the health sector in the end of 2008. Since then, the country has been struggling to restructure the health care sector and on top of that, it has been facing an increasing threat of non-communicable diseases.

The district of Bulawayo has so far not received any specific plan of action from the Ministry of Health regarding diabetes control and prevention. There are only a few initiatives at the local level. In the rural areas, there is a particular lack of physicians trained in basic diabetes management and diabetic foot care. Consequently, people living with diabetes are poorly self-managed and do not receive the appropriate care at the primary level                                                        

Objective
The objective is to improve diabetes care in Bulawayo, Zimbabwe, by establishing clinics and training health care personnel in diabetes management, prevention of foot care and education of patients.

Approach
Association pour la Promotion de la Santé (APSA) International who has previously implemented projects on the ground in both Burundi and Botswana and partnered with the WDF will be working under the umbrella of Health, Education, Food Security Organization (HEFO), a local non-governmental organization. Whilst this will be a joint partnership, APSA will be the main focal point handling the project implementation in the district of Bulawayo, Zimbabwe.

The project activities has three main objectives:

1. Six  referral clinics will be established and equipped with the basic equipment in the district of Bulawayo. A patient clinical information sheet and registry for monitoring patients will be set up. This will provide a more comprehensive data collection to improve diabetes management and follow up. A sample of 80 patients will be analysed during the course of the program in regards to their adherence to the educational sessions, as well as for risk factors and disease management. In addition, people at risk will be screened and posters for diabetes awareness will be placed in various clinics throughout the region.

2. Health care professionals (HCP) competence will be built to enhance their skills in giving more accurate diagnoses. The training will have focus on diabetes management, step-by-step foot care and wound management. Further, selected HCPs will receive TOT training and will be responsible for transferring their knowledge to other HCPs from the district clinics.

3. Finally, nurses will receive training to cater for patients and group educational sessions on how to improve patients’ involvement and awareness of their responsibility towards self-management and a healthier lifestyle. An educational booklet will be also developed taking the local context into consideration.

Expected results
•    3000 people screened for diabetes
•    6 referral diabetes clinics established
•    200 diabetes awareness posters placed in 19 clinics
•    123 HCPs trained in advanced diabetes management
•    31 HCPs attended an advanced foot care training
•    2000 diabetes patients received foot examination
•    121 HCPs trained in diabetic wound management 

Results at completion

•    6580 people screened for diabetes
•    19 referral diabetes clinics established
•    200 diabetes awareness posters placed in 19 clinics
•    124 HCPs trained in advanced diabetes management
•    62 HCPs attended an advanced foot care training
•    641 diabetes patients received foot examination
•    123 HCPs trained in diabetic wound management