Diabetes Agents for Change Project

The project was developed to address an identified knowledge gap among doctors and healthcare workers who are ill-trained in terms of providing timely diagnosis as well as proper care and management of diabetes. As a result, patients experience a lack of trust in the system, leading to extremely low rates of adherence to treatment and follow up. There is a need for changing the mindset of health care professionals from the acute model of patient care to a more holistic, long-term and empathetic chronic care model. Many health care practitioners (HCPs) themselves are overweight and at risk of diabetes, so the project is based on the concept of providing them with the skills to change their own health, which is a prerequisite for motivating their patients.

As part of the project, 270 health care workers from disadvantaged, rural areas throughout South Africa will undergo a series of training sessions with the goal of sensitising them, increasing their knowledge, changing their behaviour towards a healthier lifestyle, and changing their attitudes towards diabetes. The participants will comprise a variety of HCPs usually dealing with disadvantaged patients - including primary physicians, nurses, health promotion assistants, dieticians, pharmacists, therapists, and community leaders.

The project consists of two teaching modules both employing a participatory approach using role plays, motivational techniques – the "Agents for Change" course and the "Empowering the Patient" course. As part of the project, nine multidisciplinary groups of 30 health professionals will undergo a two-day training session on patho-physiological aspects of diabetes, detection and management, medication, nutrition and lifestyle education, communication skills etc.

Six months later, the same team of health care providers will undergo a two-day refresher and follow-up course on the same topics covered in the first session, but now focusing on providing tools for empowering patients and applying effective diabetes management and education. Each of the 270 trained HCP will be made responsible for disseminating their knowledge to ten of their colleagues. Moreover, they will be encouraged to form support groups among their diabetes patients. It is expected that approximately 10,800 people will benefit from improved care and support.

In the longer run, the plan is to train health professionals/health promotion assistants in every clinic in the target areas, who have a new long term attitude towards diabetes; have carried out lifestyle modifications themselves; have established support groups; have the skills to provide quality health care to people with diabetes and raise awareness of the disease, its complications, and the consequences of unhealthy lifestyles.

Health

As of 2012, accomplishments have included:

• 95 different rural health care professionals have been trained in diabetes care and management (including 8 doctors, 48 nurses, 1 pharmacist, 10 dieticians, 2 paramedics and 26 health promotors).
• 950 colleagues of the health care providers trained in diabetes assessment and follow-up.

At least 95 people with diabetes or at high risk have been reached through improved care and support.