Improving access to diabetes care, Liberia


Estimates from The International Diabetes Federation's (IDF) Diabetes Atlas fourth edition reveals that more than 60,000 out of a population of 1,800,000 adults suffer from diabetes in Liberia.

People with diabetes in Nimba County are affected severely by a lack of proper medication and care. This is a result of a shortage of doctors and especially doctors trained in diabetes care. Consequently, most Liberians are untreated with their disease and are not seen by a doctor before severe chronic complications occur. This will not only affect the individual but it will also become a burden on the family, the community and the society.
Therefore, the need for upgrading the health care system in diabetes awareness and care is substantial.

The objective of the project is to improve access to diabetes care and improve diabetes self-management by integrating a diabetes care program within the existing health care system and by expanding the reach using train the trainer model.


Ganta United Methodist Hospital and Primary Care (GUHM) and Nimba County Health Office are implementing this first WDF-supported project in Liberia. It will be initiated in Nimba County as a pilot project and if successful it will be expanded to other counties of Liberia.

The present project will be initiated in an already existing hospital (GUMH) and in the surrounding area consisting of 25 village clinics. The project will use a community based primary care system to integrate the diabetes program.

With the intention of ensuring the quality of care and improving access to diabetes education, health care professionals will be trained in diabetes diagnosis, management, treatment and care. Keeping the limited health care capacity in mind, the project will commence with training of two diabetes nurse specialists; one will focus on the hospital setting; and the other will have the community program in focus. However, they will work collaboratively to ensure symbiosis between the hospital and the community.

Training of the two diabetes nurse specialists will be conducted by diabetes specialists from the U.S. who will later serve as mentors and consultants. The training will be based on the IDF's Diabetes Training Manual adapted to Africa and Liberia specifically (WDF02-006 and WDF02-007 used the IDF Africa Training Manual and Practice Guidelines successfully).

The newly trained nurses will further provide education for health care workers, midwives, physicians and physician's assistants using "Train-the-Trainers" approach. Upon completion of training, the health care professionals are expected to be able to educate people with diabetes in monitoring their chronic condition.

Furthermore, health education will be arranged at the hospital and in the villages where education material covering all aspects of diabetes will be distributed to families affected by diabetes. The education material will consist of small booklets adapted to local languages. Education will increase knowledge of diabetes among people with the disease, their families, and the community - thereby improving awareness, care and outcome.

In order to increase the awareness about diabetes, an awareness and screening campaign will be conducted weekly in the hospital and quarterly in the 25 villages throughout the county. It is anticipated that a total of 5,000 people will participate and benefit from these camps.

Additionally, 400 families will be counselled and educated by the trained health care professionals. This will empower the families in self-management of their condition and thereby avoid time-consuming visits to the hospital.

Finally, two support groups will be organised in Ganta and in Sanniquellie Town, gathering around 100 people with diabetes from the surrounding area. This will prompt a feeling of fellowship amongst the people affected by diabetes, strengthening them in self-management and providing them with a forum to discuss experiences, problems and advices.

Results at completion

• 2 diabetes nurse specialists trained
• More than 160 health care workers trained
• 130 midwives and community based health care workers trained
• More than 5850 people were screened and educated about diabetes

Project information

  • Project Nr.:
  • Project status:
  • Intervention areas:
    Access to care
  • Region:
  • Country:
  • Partners:
    Ganta United Methodist Hospital
  • Project period:
    2009 2015
  • Project budget:
    USD 42.000
  • WDF contribution:
    USD 42.000