Training initiative in Rwanda*
* Summary of a report by the Association Française des Diabétiques (AFD) entitled ‘Formation sur le diabète de 28 professionnels de la santé (niveau infirmier) au Rwanda’. Click here to download the full report (in French) as a pdf file.
When: July 4-18 2005
Partners: Association Française des Diabètiques (AFD) and Association Rwandaise des Diabètiques (ARD), with the collaboration of the Rwandan Ministry of Health. The project was supported by the World Diabetes Foundation (WDF).
Aim: The initiative set out to train healthcare providers (nurses and educators) working in health centres and dispensaries to provide diabetes education for people with diabetes to help them actively manage their condition.
Objectives:
- increased knowledge of diabetes and its treatment
- improved diagnosis of diabetes
- development of screening for diabetes and its complications
- provision of appropriate insulin therapies
- effective assessment of urgent situations
- development of services providing dietary advice
- development of counselling services
- development of primary care capabilities
- effective patient referral
Diabetes in Rwanda:
- Estimated prevalence of adults: 1.1%, amounting to 88 000 people with diabetes in the country. This figure is considered an underestimate as diabetes is frequently undiagnosed in the country.
- Type 2 diabetes appears to be more common among the wealthier urban populations while type 1 is more frequent in rural areas.
Main problems identified during preliminary survey on diabetes care in Rwanda:
- Lack of healthcare professionals
- Lack of diabetes training
- Difficulty in accessing diabetes care and medication (eg. insulin and other diabetes supplies)
Training project:
- 28 participants from the various regions of Rwanda (all with a minimum qualification of nurse grade A1)
- Training conducted by two members of AFD and two Rwandan doctors (an internist and a general practitioner)
Outcome:
- All 28 participants completed the training
- All participants expressed the wish to integrate what they learnt into their respective workplace.
- Obtaining recognition from the national health authorities was very important to the success of the initiative. The training allowed participants to have an open and constructive dialogue with representatives from the Ministry of Health.
- Participants requested the development of a diabetes algorithm (similar to those existing for HIV aids and malaria) to integrate diagnoses of diabetes into the basic healthcare structure.
- The training was made possible thanks to the presence of a well-structured association for people with diabetes in the country.
- The collaboration with local health professionals was key to the success of the training.
- Local and national media coverage of the initiative played an important role in raising awareness of diabetes as a serious condition.
What next?
- ARD initially requested training for 120 healthcare professionals in 12 provinces. AFD believes that further training could be carried out by local health professionals, without the direct supervision and participation of the French association.
- The 28 healthcare professionals that were trained will undergo an evaluation process after 8-10 months.
- AFD will prepare a preliminary report on the access to and availability of insulin and diabetes supplies in Rwanda.
- AFD plans to report on the activities in Rwanda at the 19th World Diabetes Congress in South Africa next year.
- AFD may support some local projects in Rwanda proposed by affiliates of ARD.
