Recurring armed conflicts in Congo have resulted in high degrees of poverty and a weak health care system. Consequently, access to diabetes care is lacking and attention has been sparse. However, the situation is slowly changing. Diabaction-Congo has established the first medical-social centre called Diabcare and, currently, the country is in the process of elaborating its national programme for the fight against non-communicable diseases (NCDs). Nevertheless, there still is a substantial need to reinforce the existing Diabetes Health Centre and to enhance a national replication of the Diabcare experiment with a view to strengthening prevention of diabetes and its complications.The project aims to reinforce prevention and treatment of diabetes.
The partner, Diabaction-Congo implements the project in collaboration with the Ministry of Health, University Numerique Francophone Mondiale and WHO.The intention is to strengthen the capacities of the Diabetes Health Centre in Brazzaville and to replicate the acquired experience in the 3 larger cities: Pointe-Noire, Gamboma and Dolisie.The project seeks to upgrade and expand diabetes care through 3 components:• Strengthening diabetes prevention and treatment• Ensuring epidemiological surveillance• EvaluationThe first component focuses on training of health care personnel in diabetes management and its risk factors. Approximately 42 health care personnel from all the project sites will be trained. In addition, from each of Congo's 9 provinces 1 doctor and 1 nurse will participate in a working group on diabetes and associated illnesses. Similar working groups for decision makers and journalists will be organised. Furthermore, support is given to the Congo Diabetes Association to carry out early screening for diabetes in at-risk populations and to make the IDF guidelines for type 2 diabetes care available to health care professionals and people with diabetes. Health care personnel will receive training in collection and use of relevant patient data, making pertinent laboratory tests, cardiac tests and diabetes treatment available at low cost. Finally under this component, the project seeks to ensure treatment of eye complications as well as diabetic foot complications through procurement of lasers and establishment of foot clinics.The second component aims to ensure epidemiological surveillance of diabetes. This will be done by training health care personnel in collection and use of data and establishment of a database. In addition, an epidemiological diabetes register is created to provide better information for decision-makers. A report will be prepared, supporting actions regarding diabetes on a long term basis.The final component is evaluation of the project structures, which includes an in-depth study of the operations of the Diabcare centres and the training methods used. The evaluation also looks at the existence of personnel with appropriate competencies within the community as well as the turnover and motivation of health care personnel. Lastly, the evaluation will focus on the quality of the overall services provided by the Diabcare centres and an analysis of the real cause for utilisation of the centres.
• 4 Diabcare Centres have been established in Brazzaville, Pointe Noire, Gambona and Dolisie. Staff at all locations except Dolisie has been trained.• 161 pilotes for diabetes have been established at integrated healthcare centres in 11 departments, covering 11 out of 12 departments in the country.• 50 doctors and 335 nurses have been trained.• 94 paramedics have been trained, including midwives, laboratory technicians and pharmacists.• 17,668 people have been screened for diabetes. 3,691 were detected with diabetes or pre-diabetes.• A national NCD policy including diabetes has been established at the beginning of 2008. The present project activities feed into this policy and are supported by the health authorities.