Center for Health Market Innovations (CHMI)

Programs

Diabetes Care in Nairobi slums

last updated Jun 25, 2012

Overview

Implementing organization: 
African Population & Health Research Center
Implementation Partner(s): 
City Council of Nairobi, Kenya Diabetes Management and Information Centre and Provide International
Legal Status: 
Year Launched: 
2008
Stage: 
Existing/expansion stage
Income Level of Target Population: 
Bottom 20%

Funding

Primary Source of Funding: 
Donor
Additional Source(s) of Funding: 
Government

Scale

Personnel Employed: 
10-49
Number of Facilities Operated/Networked: 
3 diabetes and hypertension clinics
Other Measures of Scale: 
30 clinicians trained; 50 nurses and 10 nursing assistants trained; 24 community health workers trained
Summary: 

The project is improving access to diabetes care and management for slum dwellers in Nairobi by establishing and running an outreach clinic in already existing facilities in each of the three slums.

Program goals/rationale: 

Rapid urbanisation is contributing to an increase in the incidence of non-communicable diseases like diabetes and hypertension in sub-Saharan Africa. Mass migration from rural areas in search of better opportunities is not only increasing the risk of lifestyle diseases but is also fostering the growth of slums as exemplified by Nairobi where several hundred thousand urban poor now reside in slums.

Although some health facilities do exist in the slums, these are often of questionable quality, focussed on emergent care and are poorly utilised. As a result, diseases of all kinds prevail, including diabetes and hypertension that are further fuelled by high levels of health-related risky behaviours such as alcohol consumption, tobacco use and poor diet. As a consequence of these socio-economic determinants, outcome of care is very poor.

Key program components: 

By establishing and running an outreach clinic in each of the three slums, the project aims to improve the management of diabetes, its co-morbidities, and complications with an emphasis on promoting self-care, compliance to treatment and lifestyle changes.

The clinics will be set up in existing primary health care facilities. Each clinic will be run on a fortnightly basis on weekends and manned voluntarily by four clinicians, two nurses, a counsellor and an assistant. Staff will be available to offer counselling and consultation outside of the clinic's normal opening hours in more urgent situations. Health care personnel manning the service will be trained in the principles of diabetes care and management based on current guidelines and existing training materials developed by Kenya Diabetes Management and Information Centre.

Once a month, a specialist physician will visit the clinics to deal with complicated cases. The work carried out at the clinics will focus on promoting self-care, monitoring of blood glucose and blood pressure, and management of complications. Once the patient's blood glucose and blood pressure are controlled, health workers will conduct home visits to the patients to check that things are proceeding well.

450 people with diabetes and 2,250 people with hypertension will benefit from the improved care available to them at the clinics.

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