Implementation and evaluation of a specialized diabetes clinic in Guinea-Bissau: lessons learnt from the field

The Pan African Medical Journal

Victor Madrigal¹  Carlos Reguera Errasti¹  Adalgisa Lopes²  Adramane Nhabali³  Montserrat Castellsague Perolini⁴  Emer Brady⁵  Michelle Hadjiconstantinou⁵  Jorge César Correia⁶ 

[1] Aida Ayuda Intercambio y Desarrollo (AIDA), Bissau, Guinea-Bissau;Association Suisse d´Aide aux Personnes Diabétiques en Guiné-Bissau, Geneva, Switzerland;Department of Internal Medicine, Hospital Nacional Simão Mendes, Bissau, Guinea-Bissau;Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland ;Leicester Diabetes Centre, University Hospitals of Leicester, NHS Trust, UK;Unit of Patient Education, Division of Endocrinology, Diabetology, Nutrition and Patient Education, WHO Collaborating Center, Department of Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland;

关键词: diabetes mellitus;    guinea-bissau;    training programs;    consultation clinics;   

DOI  :  10.11604/pamj.2020.37.126.26127

来源: DOAJ

【 摘 要 】

INTRODUCTION: diabetes care in Guinea Bissau (GB) is characterized by a lack of properly trained healthcare professionals (HCPs) and guidelines for diagnosis, treatment and follow up of patients. To address these issues, this project was launched with the objective to train HCPs in the management of diabetic patients and establish a specialized diabetes clinic in the Hospital Nacional Simão Mendes, a public tertiary care hospital in Bissau, capital of GB. This project is led by the Geneva University Hospitals (HUG) in collaboration with the Swiss Association for the Aid to Diabetic People in Guinea-Bissau, with the support of the International Solidairty Office (SSI) of the State of Geneva, and AIDA (Ayuda, Intercambio y Desarrollo). METHODS: specialists from the HUG in collaboration with local experts in GB developed and delivered a culturally and contextually adapted training course pertaining to diabetes care to HCPs in this hospital. Pre and post training tests were conducted to assess differences in knowledge and practices. Following the training program, a diabetes clinic was set up and an audit was conducted to assess its performance. RESULTS: a total of 24 HCP attended the training program and exhibited statistically significant improvements in their knowledge pertaining to diabetes care (mean difference between pre and post-test = 14.53, SD 11.60, t=-4.8, p= 0.001). The diabetes clinic was established and provided consultations 2 days per week. A total of 63 patients consulted at this clinic, of which 49 had type two diabetes treated with oral antidiabetic drugs and 14 were type 1 diabetics treated with insulin. Patients had blood glucose measurements and recieved therapeutic, dietary and physical activity counselling. Several barriers leading to occasional interruptions of service were encountered, including a political instability in the country and strikes of healthcare staff demanding better wages and working conditions. CONCLUSION: this study delineates the feasibility of setting up a diabetes consultation clinic in GB despite important barriers. To ensure successful running of such consultation clinics, continued buy-in and support from stakeholders should be ensured. Diabetes training should be incorporated in pre-and post-graduate training curriculums of all HCP to help shape a better workforce.

【 授权许可】

Unknown