The successful implementation of the WDF funded project "Improvement of access to diabetes care" (WDF06-187) placed diabetes on the health agenda in Burundi and the Government has now made combating diabetes one of its priorities.The prevalence of diabetes in Burundi is stated to be as high as 7.3% in rural areas where more than 90% of the population resides. The rural population of Burundi is not only severely affected by diabetes; they are also the most vulnerable to its consequences as proper health care often is out of reach. Given this challenge the focus of the Government on diabetes is most appropriate.Most health care professionals prefer working in urban areas. As a consequence, health facilities in rural areas lack doctors and nurses trained in the prevention and treatment of diabetes. Added to this, is the issue of lack of even the most basic equipment for screening and monitoring, which practically means that the majority of people with diabetes are not diagnosed, and those diagnosed are poorly treated and not surprisingly causing high rates of morbidity and mortality.The objective of the project is to enhance primary prevention of diabetes and also to improve access to diabetes care.
The previous project WDF06-187 achieved a number of objectives including a sensitisation workshop for decision-makers and screening of more than 3,000 people. Data collected in relation to the project revealed a high prevalence of diabetes in rural areas. The project partner on WDF06-187, Centre de Lutte Contre le Diabète au Burundi, applied for and was granted support from the WDF to implement this current project with the purpose of improving access to diabetes care in rural areas - more specifically in the two provinces Bujumbura Rural and Cibitoke in the western part of Burundi. The project will help strengthen the existing public health system to be better able to deal with the burden of diabetes in the project areas.The main component of this project consists of training various groups including health care professionals and people with diabetes.To ensure that health care staff at all levels have the necessary knowledge and capabilities, training on treatment of diabetes and hypertension will be arranged. All the 13 doctors in the provinces will be trained during two training sessions - one in the first year and one in the second year - with a duration of five days and subsequent supervision at the local hospital. Further, 100 nurses selected from each province, will participate in a training session lasting four-five days. Finally, to ensure that the laboratory assistants are able to perform the required tests, 64 of them will receive two days of training.Moreover, 30 community health officials from each province will be trained twice each year for two days. Their role will be to organise awareness raising activities and provide information on diabetes and hypertension to the population and thereby increase the knowledge of the general population. The community health officials will be selected by the other members of their community on the basis of certain criteria such as moral integrity, permanent residence within the community, a certain level of education and willingness to carry out unpaid voluntary work.Among people with diabetes in the provinces, 40 will be chosen to be trained as peer educators on the basis of their suitability to convey information about self-care and the desire to take on the role as a peer educator. The peer educators will be trained for two days annually on how to educate and motivate people on self care to get better control. The peer educators will also help strengthen mutual social support and solidarity amongst people with diabetes.To ensure that the essential equipment is available at the health facilities in the provinces, five hospitals and 50 health centres will be provided with various equipment including blood glucose meters and blood pressure meters.Finally, a workshop will be carried out to raise awareness among decision-makers and fund-providers, to sensitise these people about the extent and seriousness of diabetes in Bujumbura Rural and Cibitoke and the necessity of setting up strategies to make drugs and other diabetes supplies necessary for treatment easily accessible.Thus, by training community health officials, health care staff and peer educators and by the same time ensuring that the required equipment and drugs are present at the health facilities, this project will enhance primary prevention of diabetes and at the same time improve access to care and thereby increase the quality of life for people with diabetes in Bujumbura Rural and Cibitoke.
• 13 doctors trained • 200 nurses trained • 64 laboratory assistants trained • 714 community health agents and officials trained • 40 peer educators trained • 64 health facilities strengthened