The WDF funded project WDF05-124 has produced results which have provided the basis for the Ugandan Ministry of Health to plan and implement a National Diabetes/NCD Programme.The Programme will include development of a policy, standards, guidelines and an integrated, comprehensive work plan for the prevention, detection and control of diabetes and related non-communicable diseases (NCDs).Such a programme is crucial since the burden of NCDs such as diabetes and hypertension is increasing apace in Uganda and yet the availability of care and awareness of diabetes is lacking. Therefore, WDF is supporting the Ministry of Health in its efforts to set up and implement a National Programme.The National Programme seeks to improve prevention, detection and control of diabetes and other related non-communicable diseases (NCDs).
The intervention is designed as a comprehensive National Diabetes/NCD Programme directed at the entire Ugandan population of approximately 30 million people and aimed at the prevention, early detection and control of diabetes including the provision of quality treatment. The Programme constitutes the first WDF funded National Programme.The Prevention and Control of NCDs Division of the Ministry of Health will be heading the Programme which will be run through existing structures and systems of the Ministry of Health in collaboration with other stakeholders such as other ministries, NGOs and universities.While aiming for a comprehensive and holistic approach to diabetes/NCD care in Uganda, it is not feasible to address and cover all aspects in this first phase of the Programme. The outlined components in the Programme represent the key focus areas identified by the Ministry of Health. Subsequent phases may include more or other components.Component 1 deals with policy, guidelines and standards. An essential part of the Programme is the development, formulation and implementation of a national diabetes/NCD policy, standards and guidelines to guide prevention and control of the diseases and ensure universality of best practise. The finalisation of these will involve a broad range of stakeholders. Component 2 focuses on capacity building for improved diagnosis and care. The knowledge and skills of health workers for diabetes/NCD prevention and care are inadequate. Therefore, a needs assessment on their knowledge and skills to manage diabetes and its complications as well as related NCDs will be conducted. This will be followed by tailored training to address the identified knowledge and skills gaps among the health workers.Following the training of health care workers, a minimum of 51 diabetes/NCD clinics will be established, covering primary, secondary and tertiary health care levels. 11 of the clinics will be model clinics located at regional hospitals and the remaining 40 will be standard clinics at Health Centre IV. In addition, all clinics will receive educational materials for the patients. All the clinics are established within existing Ministry of Health structures.The care capacity building component of the Programme further builds upon two other WDF funded interventions in Uganda which have led to the establishment of 40 diabetes clinics throughout the country: WDF06-180 and WDF06-199.In addition to training health care workers on diagnosis and care, emphasis is also placed on prevention of diabetes related complications, in particular the diabetic foot. Training of the clinic teams will be conducted using the WDF funded model: Step-by-Step which seeks to ensure adequate attention to the feet of the patients and thereby prevent unnecessary limb amputations. The Step-by-Step model was developed and implemented in India and Tanzania through WDF03-056.Component 3 addresses awareness. Traditional healers play an important role when people seek health care in Uganda. However, knowledge about diabetes symptoms and signs is often lacking among this group as is knowledge of what can be treated and what cannot be treated by traditional healers.As a result, the healers tend to hold on to these patients for too long before referring them to health facilities for proper management. Or they may attempt inappropriate - at time life threatening - treatment methods. For this reason regional traditional healers' sensitisation workshop will be conducted for all regions.Furthermore, there is a general need to raise the level of awareness of diabetes, including its risk factors, prevention, early symptoms and complications among the Ugandan population.This component of the Programme will include activities raising awareness and promoting healthy lifestyles, community based interventions and activities specifically aimed at schools and workplaces.Component 4 focuses on nomadic and internally displaced population groups.Certain parts of Uganda host smaller or larger groups of internally displaced groups. The country also has nomadic population groups which need to be reached with health care initiatives. This component of the Programme seeks to reach these groups with awareness as well as to identify the most appropriate way of providing care to hard-to-reach areas/population groups.Apart from the above listed intervention components, the Programme contains activities for supervision and monitoring of implementation, strengthening the NCD Division in the Ministry of Health for advocacy and action as well as disease and complication surveillance for measuring outcome levels.
• Improved access and quality of diabetes/NCD care for the Ugandan population • Development and implementation of a policy, standards and guidelines for the prevention and control of diabetes and related NCDs • At least 51 diabetes/NCD clinics created throughout the country • Increased awareness of diabetes/NCD at its risk factors. Activities conducted among the general population as well as in schools and work places• Sensitisation workshops for traditional healers conducted in all regions• Prevention of diabetes complications with particular emphasis on the diabetic foot