SUCCESSFUL COMPLETION OF WORLD DIABETES FOUNDATION CO-FUNDED PROJECT (WDF15-1257)
Talabi Diabetes Centre, in collaboration with the Ogun State Local Government Service Commission and the Ogun State Chapter of the Diabetes Association of Nigeria have successfully completed its Project titled:Enhancing Diabetes Education and Care in Ogun State (WDF15-1257).
The Project GOAL is to improve knowledge and strengthen the skill of Primary Healthcare Workers in Ogun State to deliver basic diabetes care.
Project period: October 1st,2016 to December 1st 2018
Funding: TDC; supported byWorld Diabetes Foundation’s (WDF) USD 100,000 part-funding Grant.
1.Ogun State Local Government Service Commission
2. Diabetes Association of Nigeria, Ogun State Branch.
Problemsthe project set out to address
Nigeria’sHealthcare System is divided into three tiers, namely:
Primary – (Health Centres, the first point of call in the communities)
Secondary— (General Hospitals)
Tertiary- (Teaching Hospitals and Specialist Hospitals).
Prior to this project, Diabetes care in Ogun State, as in other States,was majorly carried out at the Secondary Level of care in the State’s General Hospitals and in the two tertiary Hospitals in the State, namely:
Olabisi Onabanjo University Teaching Hospital, Sagamu
Federal Medical Centre, Abeokuta.
To the best of our knowledge, at the time the Project was being contemplated, Talabi Diabetes Centre was the only Centre delivering comprehensive Diabetes Care at the Primary Care Level in Ogun State.
According to the World Bank Year 2014 Report, 54% of Nigerians live in rural areas where the first level of Healthcare is the Health Centre. This informed therefore, thatbasic and functional Diabetes Care need to be made available at this level of Care if indeed the Government is desirous in stemming the incidence of diabetes and its deadly complications in the State. To achieve this deserving goal, it is imperative that the Primary Healthcare Workersbe adequately empowered for the job by furnishing themwith up-to -date knowledge about diabetes and equipping them with basic Diabetes Care tools.
The objective of the project was to redress the present shortcomings of the State’s Health Centres. The project was therefore designed to achieve this through the following strategies:
1. Improve the knowledge base of 1,000 primary Healthcare Workers on diabetes.
2. Improve the ability of 1,000 Primary Healthcare Workers to deliver meaningful andhelpful Diabetes Education and Care thereby improving the lives of people living with (and without) diabetes in their communities.
3. Furnish the participating 100 State Primary Healthcare Centres with Glucose Monitors and Strips.
4. Screen 25,000 individuals who present to the various Primary Healthcare Centres for diabetes.
1,000 Primary Healthcare Workers from the 4 Health Zones of the State were scheduled to undergo a 3-day Update Course in Diabetes. Practical sessions such as Glucose Monitor handling were incorporated into the Course. To minimize the disruption of the day-to –day operations at the participating Health Centres during this period, lectures were delivered in two phases.
100 Primary Healthcare Centres in Ogun state were scheduled to be furnished with Blood Glucose Monitors and Strips, Monofilaments and Blood Pressure Monitors. These strips were to be used to screen a total of 25, 000 individuals who present to the various Primary Healthcare Centres for Diabetes and Hypertension.
Adopted strategies for Project Goal Realization
Strategy 1: Improve the knowledge base of 1,000 Primary Healthcare Workers on Diabetes:
This strategy was helpful in achieving the Project Goal even though only 946 (94.6%)out of the expected1,000 participants were present for the Training Sessions— (others, (54no) were absent for a variety of reasons such as ill-health, maternity leave, etc).
Strategy 2: Improve the ability of 1,000 Primary Healthcare Workers to deliver meaningful and helpful Diabetes Education and Care thereby improving the lives of people living with diabetes (and without) in their communities.
This strategy achieved the set objective: the 946 Primary Healthcare Workers who attended the 3-day Training Sessions in their various zones were exposed to and lectured on the various aspects of Diabetes and Hypertension. The practical sessions on Foot Care, Glucose Monitor use and Diet Classes also enhanced their skills.
Strategy 3: Furnish the participating 100 Primary Healthcare Centres with Glucose Monitors and Strips.
This strategy did not only achieve the set objective of the project, it ended exceeding the set goal of furnishing 100 Centres with tools. At the end of the project, 300 Primary Healthcare Centres were furnished with Glucose monitors and strips due to prudent resource management.
Strategy 4: Screen 25,000 individuals who present to the various Primary Healthcare Centres for Diabetes and Hypertension.
The objective of this strategy is being achieved gradually. At the moment 13, 771 individuals, being the approximate number of people who passed through the various Primary Healthcare Centres during the Project period were screened. The screening exercise is however ongoing; TDC is confident that the projected number of 25,000 will not only be achieved, but it will be surpassed in the coming months.
Of the 13, 771 individuals screened for diabetes, 990 (7.2%) had abnormal blood sugar levels. Of these, those with complications like eye or foot problems were referred to the next level of care while those without complicated diabetes were managed at the Primary Healthcare Centres.
Sustainability of theProject outcome
The long term sustainability of the gains of the Project is not in doubt, as:
Each Primary Healthcare Centre that was strengthened has the capacity to continue to replenish its Glucose Monitor Strips and Glucose Monitors.
The communication line between the Primary Healthcare Centres and Talabi Diabetes Centre will be kept perpetually opened: they are free to contact the Centre for advice not only on Patient Care but also on technical issues concerning their care-delivery tools--- glucose monitor metres, strips etc.
In addition to giving every participating Healthcare Worker a copy of the Training Manual used for the Update Course, each Health Centre was given a copy for reference purposes. This will ensure that adequate information is always at the easy reach of each Centre and that the gains of the project survive the health institutions’ staff turnover.
The Ogun State Local Government Service Commission which collaborated actively on this project is also fully committed to its Oversight Function over all the strengthened Primary Healthcare Centres.
Major achievements and challenges of the project
1. The project has made basic Diabetes Care available in Primary Healthcare Centres in Ogun State, Nigeria. This is the first of its kind in Nigeria.
2. Training of 946 Primary Healthcare Workers of the State on Diabetes Care
3. Strengthening of 300 State Primary Healthcare Centres with basic Diabetes Care Equipment.
4. Screening of 13, 771individualsin the community for diabetes.
1.Reduction in the number of training days by 1 day in a Zone due to an unscheduled National Immunization Day Outreach which required the mandatory participation of all the State’s Primary Healthcare Workers.
2. The large number of Primary Healthcare Workers who have been educated on Diabetes Care but who are yet to be empowered because their Health Centres could not be equipped.
Comments of some stakeholders
‘I am very gratified to see the outcome of this project. It has impacted tremendously on our people in the rural areas. We wish you could supply drugs too. We look forward to more areas of collaboration with the World Diabetes Foundation and Talabi Diabetes Centre in the not too distant future’---- Honourable Tunde Rahman, Chairman, Ogun State Local Government Service Commission.
‘Please ensure that all our colleagues and all our health Centres benefit from this project. It will be very frustrating to undergo this training and have no equipment to work with’---Ayantayo Temilola, Chief Nursing Officer, Ilara Primary Healthcare Centre.
‘We must appreciate Talabi Diabetes Centre and the World Diabetes Foundation for this initiative. I remember the SIDCAIN program also and the benefits we received from it. Please keep it up. We are happy to have collaborated with you on this project. There is still a lot more work to be done’---Mrs C.D.A Adeyiga, Secretary, Diabetes Association of Nigeria, Ogun State.
‘Thank you very much. I have learnt a lot of things that will benefit my patients and me also’- --Akinyemi Zainab, Community Health Officer, Ilese Primary Healthcare Centre.
‘Well done to us. It has been a tough but rewarding exercise’- ---Funmilayo Adediji, Community Health Officer, Talabi Diabetes Centre.
Dr Olubiyi Adesina
Centre Coordinator/Project Responsible