Adesina O, Talabi J, Solarin T, Johnson T
There is little formal diabetes care at the Primary Health tier in Nigeria. At that level, services have remained mainly focused on communicable diseases.
The Talabi Diabetes Centre is a community based facility in the rural community of Ishara in Western Nigeria. The Centre collaborates with the local Diabetes Association, the State University Medical school and the health agencies of the local and state governments. It seeks to minimize the incidence of diabetes in the community, provide quality diabetes care and carry out research for the fight against diabetes.
The health teams comprise a few Doctors working with Nurses, Community Health Extension Workers, and Health Technicians of the Local Government, National Youth Service Corp members, community volunteers and members of the local chapter of the Diabetes Association of Nigeria.
Capacity building is undertaken mainly by regular and continuing on-the-job training.
Recently, the Centre carried out public campaigns in some major markets and adjacent community settlements. Key information was given through radio jingles and the distribution of pamphlets written on diabetes in English and the local languages. Adult subjects were screened for diabetes.
Through the jingles, awareness reached some 2.5 million adults in the community. Over 5000 educational pamphlets were distributed and of the 2655 individuals surveyed, 1766 were screened for diabetes. Persons with diabetes and those at risk for diabetes were counseled in the field and referred to the Talabi Diabetes Centre and the primary care clinics of the local government for care and follow-up. Within the year the Centre recorded 450 persons with diabetes on its register. Patients with complications of the disease are referred according to "Standing Orders" to the higher tiers of care in the State and University Teaching Hospitals.
The delivery of diabetes care to rural and poor communities is a challenging exercise in Nigeria. Capacity building and updating of available staff to deliver services can be executed at little extra cost.
The presence of the Talabi Diabetes Centre in this rural setting is providing and strengthening community awareness, diabetes education and at the same time is offering care and preventive services to the community.
Lessons learnt should make it serve as a model for integrating diabetes into the broader health care system of the country.