Improving access and quality of diabetes care in rural Zimbabwe

Objectives

Implement a stepwise decentralisation of standardised diagnosis, treatment and follow up of diabetes patients, moving these tasks to the primary level within three districts in Masvingo Province, Zimbabwe.

Approach

SolidarMed (SM) has been operating in Zimbabwe since 1975 and has extensive health experience and a long-term partnership with the Ministry of Health to strengthen HIV/AIDS and TB care.

In recent years SM has focused on NCD care. The organisation is commissioner of the NCDI poverty commission (2019) and an active contributor to local partner decentralisation and protocol development.

In this project, SolidarMed Zimbabwe will manage funds, coordinate and monitor partner organisations.
The effort to decentralise diabetes care will take the following approach:

1. Coordinate stakeholders to define and implement national NCD indicators, and hold regular review meetings to share project results and progress

2. Strengthen capacity for diabetes care at targeted district hospitals and primary health centres by providing standard diagnostic and monitoring equipment, digitising patient booklets and standardising care and referrals as per the WHO HEARTS technical package. Furthermore, the project will build district hospital capacity to provide eye care screening of diabetes patients.

3. Roll out a training package and provide routine screening, diagnosis and management of diabetes and its complications among patients, including patients with TB, HIV and HT, at targeted health facilities. Training will consist of a 3-day classroom training followed by onsite group training at individual health facilities and ongoing mentoring of trainees.

4. Mobilise and train village health care workers already engaged in awareness activities related to HIV, TB, mental and maternal health in the districts to create awareness on diabetes and other NCD risk factors. The engagement of village health workers will be combined with broader community sensitisation meetings on NCD risk factors and healthy lifestyle, and diabetes screenings will be conducted.

5. Improve health literacy among diabetes patients and their families. This will be done via patient education sessions at targeted health facilities that are delivered by trained HCPs. Health education will be supported by targeted motivational text messages and various digital health applications, all aiming to support health information systems, patient-HCP interaction, and links to specialist care.

Expected results

18 clinics strengthened to provide diabetes care and prevention (6 district hospitals and 12 primary level clinics)
36 doctors, 210 nurses and 315 village health workers trained in diabetes care and prevention
3,400 diabetes patients gain access to quality diabetes treatment services; 80% of diabetes patients receive annual HbA1c tests and foot screening
28,500 people screened for diabetes
2,423 TB patients diagnosed with diabetes
At least 10,000 people were receive health education messages
35 diabetic retinopathy camps conducted through outreach visits