Organization of Care: Problems in Developing Countries—Sub‐Saharan Africa

Abstract

Diabetes mellitus is now a major health problem in Africa, and patient numbers will increase with the tremendous gain in life expectancy. Africa had a population of nearly 600 million inhabitants in 1998, with an estimated diabetic population of 550 000 type 1 and 5 million type 2 diabetic patients. With the current trends, it is estimated that the African diabetic population would more than double by the year 2000 and quadruple by the year 2010. Yet the health care system of most countries in the region is geared mostly toward communicable diseases. Diabetes care is integrated in the overall national health care structures, with primary care bearing the main responsibility. Diabetic patients seek care at the primary, district, or tertiary health care systems where there are geographical disparities in the availability, organization, and quality of diabetes care. Delivery of diabetes care is fraught with problems including organizational, medical, socioeconomic, cultural, and geographic factors. Governments, diabetes associations, and other bodies comprising people affected with diabetes, physicians, nurses, nutritionists, and educators should cooperate with one another in improving diabetes care in the region.