Diabetes education and empowerment: lessons from rural South Africa

Price, Caroline; Shandu, D.; Gill, Geoff

doi:10.1002/pdi.1101

Cited by 8 publications

(5 citation statements)

References 7 publications

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“…We also introduced education sessions for staff (usually PHC nurses) in the form of occasional ‘Diabetes Days’ held in local community centres. Our education system was founded on established principles, both locally [12] and elsewhere [13], and has been described in more detail in an earlier publication [14].…”

Section: Methodsmentioning

confidence: 99%

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An effective system of nurse‐led diabetes care in rural Africa

et al. 2008

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Section: Methodsmentioning

confidence: 99%

“…Our education system was founded on established principles, both locally [12] and elsewhere [13], and has been described in more detail in an earlier publication [14].…”

Section: Educationmentioning

confidence: 99%

An effective system of nurse‐led diabetes care in rural Africa

et al. 2008

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“…Nutrition topics comprised the majority of the sessions (six out of eight weekly sessions) and the content covered included: food groups; healthy eating with a focus on meal balance and variety; food portion control; planning meals on a limited budget; improving vegetable supply through gardening and a cooking session. Pictorial flip charts that included the Zakhe diabetes education tool 24 (adapted with modification) and the South African Food Based Dietary Guidelines were used to teach diabetes and diet-related content respectively. 19 The modified Zakhe education tool was pretested on 10 people with similar characteristics to the participants in this study, and was found suitable.…”

Section: Interventionmentioning

confidence: 99%

Impact of nutrition education on diabetes knowledge and attitudes of adults with type 2 diabetes living in a resource-limited setting in South Africa: a randomised controlled trial

Muchiri

Gericke

Rheeder

2016

Journal of Endocrinology, Metabolism and Diabetes of South Afri

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To evaluate the effect of a nutrition education (NE) programme on diabetes knowledge and attitudes of adults with type 2 diabetes mellitus (T2DM). Methods: Eighty-two adults (40-70 years) with poorly controlled T2DM (HbA 1c ≥ 8%) and attending two community health centres in Moretele, North West Province (South Africa) participated in a one-year randomised controlled trial. Participants were randomised to the intervention group (n = 41; 8 weekly group education (2-2.5 hours); follow-up meetings and education materials) or control group (education materials only). Diabetes Knowledge Form B assessed knowledge about diabetes. Diabetes Attitudes Scale-III assessed the attitudes towards diabetes and treatment. Assessments were done at 6 and 12 months. Analysis of co-variance compared the groups (baseline, age, gender and clinic adjustments). An intention-to-treat analysis was employed. Results: The intervention group had higher mean diabetes knowledge scores + 0.95 (p = 0.033) and + 2.05 (p < 0.001) at 6 and 12 months respectively. However, the scores were below 50%. Patient autonomy for diabetes attitudes was the only score significantly higher in the intervention group + 0.27 (p = 0.028) at 12 months. Conclusion: NE significantly improved diabetes knowledge in the intervention group, though not satisfactorily, but had limited effects on the attitudes towards diabetes.

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“…At health centres in Cape Town, patients with diabetes had little understanding of how to manage hyper- or hypoglycaemia and poor knowledge of the importance of good blood glucose control 15 . The utilization of “expert patients” was advocated for in the UK in 2002 and was later used successfully in a program in rural South Africa 22 , 23 . Similar to our experience in Malawi, leaders such as school teachers, nurses or community health workers living with diabetes were selected and trained in the use of a “Zakhe” (his/hers) diabetes programme that included use of pictorial flip charts 8 .…”

Section: Discussionmentioning

confidence: 99%

Decentralising diabetes care from hospitals to primary health care centres in Malawi

et al. 2021

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BackgroundNon-communicable diseases (NCDs) such as diabetes and hypertension have become a prominent public health concern in Malawi, where health care services for NCDs are generally restricted to urban centres and district hospitals, while the vast majority of Malawians live in rural settings. Whether similar quality of diabetes care can be delivered at health centres compared to hospitals is not known. MethodsWe implemented a pilot project of decentralized diabetes care at eight health centres in four districts in Malawi. We described differences between district hospitals and rural health centres in terms of patient characteristics, diabetes complications, cardiovascular risk factors, and aspects of the quality of care and used multivariate logistic regression to explore factors associated with adequate diabetes and blood pressure control. ResultsBy March 2019, 1339 patients with diabetes were registered of whom 286 (21%) received care at peripheral health centres. The median duration of care of patients in the diabetes clinics during the study period was 8.8 months. Overall, HIV testing coverage was 93.6%, blood pressure was recorded in 92.4%; 68.5% underwent foot examination of whom 35.0% had diabetic complications; 30.1% underwent fundoscopy of whom 15.6% had signs of diabetic retinopathy. No significant differences in coverage of testing for diabetes complications were observed between health facility types. Neither did we find significant differences in retention in care (72.1 vs. 77.6%; p=0.06), adequate diabetes control (35.0% vs. 37.8%; p=0.41) and adequate blood pressure control (51.3% vs. 49.8%; p=0.66) between hospitals and health centres. In multivariate analysis, male sex was associated with adequate diabetes control, while lower age and normal body mass index were associated with adequate blood pressure control; health facility type was not associated with either. ConclusionQuality of care did not appear to differ between hospitals and health centres, but was insufficient at both levels.

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Diabetes education and empowerment: lessons from rural South Africa

Cited by 8 publications

References 7 publications

An effective system of nurse‐led diabetes care in rural Africa

An effective system of nurse‐led diabetes care in rural Africa

Impact of nutrition education on diabetes knowledge and attitudes of adults with type 2 diabetes living in a resource-limited setting in South Africa: a randomised controlled trial

Decentralising diabetes care from hospitals to primary health care centres in Malawi

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