Improving DM prevention and care, Burkina Faso

Objectives

Diabetes is one of the major causes of disabilities and deaths in developing countries. Especially the African countries are expected to have a rapid increase in diabetes prevalence in the coming years. Burkina Faso is among the countries experiencing difficulties in coping with the rising burden of Non-communicable diseases (NCDs) due to increasing urbanization and rapid changes in lifestyle. It is therefore of utmost importance to reduce the incidence of shared risk factors leading to diabetes by raising awareness and improving access to prevention and care.

Burkina Faso has been struggling to achieve the Millennium Development Goals and has a lack of human resources and limited capacity. Before 2009, diabetes management was almost non-existent outside of the capital area. A previous project supported by the WDF (WDF09-424) has contributed towards improving accessibility and quality of health care for people with diabetes in all 13 regions of Burkina Faso.

The goal of this project is to improve the quality of life of people living with diabetes in Burkina Faso, by advocating for prevention and improving access to care.

Approach

This particular project will run in parallel with the project WDF09-424 to support the decentralization of diabetes care in Burkina Faso. The goal is to make prevention and quality care available for people living with diabetes at the secondary and tertiary health care sectors. Diabetes management will be integrated at all levels and the best practices will be incorporated into the National Diabetes Control Programme. This project consists of five components:

1) A national database will be set up to monitor the progress of activities in the various diabetes clinics in the country. The database will enable two medical students to write a thesis on the monitoring process. In addition, the quality of care will be evaluated by drawing a random sample of 100 patients for analysis. A questionnaire will also be conducted to evaluate the impact of the educational and awareness activities.

2) The level of expertise of health care professionals will be enhanced in diabetes detection and management and its related complications. The capacity for patient management will be increased by providing quality health care in the nearby health care proximity, which will substantially reduce transportation costs to consultations and the burden of complications. In addition, nurses’ college training curriculum will be improved and doctors will undergo training in type 1 diabetes, diabetes foot care, gestational diabetes and therapeutic education of patients.

3) A system will be established for optimising the supply of diabetes medication to all pharmacies in the country. A reduction in medication prices will be negotiated with wholesalers and the stock will be constantly monitored in order to prevent shortages. This activity is vital for scaling up the experience gained from the activities initiated in the WDF09-424 project.

4) The diabetes associations will be empowered to advocate for quality care, defend people’s rights in order to ensure access to health, and reduce the socio-economic impact of diabetes. Thus, they will receive support in redefining their mission and strategy and in advocating for the restructuring of the health care system. This will hopefully contribute for placing diabetes onto the national agenda and for strengthening the socio-economic support given to patients.

5) Supervisory training visits will be conducted by specialists to ensure the diabetes units are conducting and providing effective diabetes treatment.

Results at completion

• 55 clinics or facilities which doctors and nurses have been trained and capacity strengthened concerning T2DM.
• 360 nurses trained in diabetes care
• 156 doctors trained in diabetes care (46 referring physicians were trained on therapeutic patient education on type 1 diabetes, 17 health professionals from trained on diabetic foot, 46 doctors trained on HIP, 47 diabetes-referring physicians in the prevention and management of diabetes)
• 11 clinics strengthened with GDM care
• National diabetes registry established
• 1 national and 13 local diabetes associations strengthened
• Diabetes curriculum strengthened for nurses in public and private nursing schools