The International Diabetes Federation indicates that in Zimbabwe, the number of adults with diabetes (age 20-79) was 99,400 in the year 2016, and adults with undiagnosed diabetes (age 20-79) were 75, 800. Diabetes Mellitus is among the nation’s top twenty causes of mortality among all ages. The Zimbabwe health system experiences difficulties in providing diabetes care. Previous studies have generated evidence that a significant number of health facilities did not have adequate tests available for blood glucose testing and the general essential medicine availability was low. The WHO states that basic medicines such as metformin and those in the sulphonylurea class are not generally available in health facilities in Zimbabwe2. Zimbabwe’s Health Delivery System, once rated amongst the best in Sub-Saharan Africa, has suffered severely in the period 2000 to 2009.
EPN with the support from the World Diabetes Foundation is currently undertaking a project with an overall goal to improve the management of type 2 diabetes in faith-based healthcare facilities in Zimbabwe. The implementing partners for the project are the Zimbabwe Association of Church-related Hospitals (ZACH) and the Zimbabwe Diabetes Association (ZDA).
The three main objectives of the project are to:
2020
Following the establishment of steering committee, MRCZ Ethical Clearance, and training of data collectors, a baseline study was conducted in December 2018 in a sample of 20 health facilities. The baseline study revealed low availability (34%) of all diabetes medicines on the current Zimbabwe essential medicines list. The baseline report contains further information on stock management and patient counselling practices.
Twenty-four (24) participants representing ZACH, EPN, ZDA, CHAZ, Novo Nordisk, Médecins Sans Frontières, and MOHCC took part in the first stakeholders meeting. The discussions were informed by the baseline study findings and lessons learnt from the Zambia project and were shared, mainly, improvement of diabetes care requires a multi–disciplinary approach and needs commitment from various stakeholders.
Supervisory visits for 40 facilities were completed. This activity has however faced much delay due to Covid-19 restrictions. Procurement of Hb1AC machine was completed and currently awaiting distribution to the health facilities.
The endline assessment of the facilities will be based on medicine availability, counselling practices, pharmacy stock management, KAP study and blood glucose testing of the patients tested at the beginning of the project. Finally, an advocacy meeting will bring together the same stakeholders to share the outcomes of the project and provide orientations for the future.
2018-2019
The project started in the last quarter of 2018 with a baseline study to establish current diabetes medicine and diagnostic tests availability, patient counseling practices and general stock management in a sample of 20 facilities. Following training of the data collectors at the ZACH offices conducted by EPN; data was collected using the Open Data Kit (ODK) software in December 2018.
The other project activities are planned for 2019 including:
- The development of Information, Education and Communication (IEC) materials;
- A training of trainers followed by the training of 100 staff from 50 health facilities
- A stakeholder’s advocacy meeting to sensitize hospital administration, government representatives, DSO representatives, and other stakeholders about the importance of ensuring sustainable access to quality diabetes medicines and diagnostic equipment in the faith-based health facilities and post-training supervisory visits
- Refresher training and evaluation will conclude the project in 2020.
