National Diabetes Prevention Plan - Cameroon
Research evidence was used to get the government of Cameroon to adopt a national diabetes programme. Studies showed that 12-16% of adults in urban areas and 5-6% in rural areas had hypertension (?160/95 mmHg) and 5-6% of men and 3% of women in urban and rural areas had diabetes.
With limited information about health promotion activity in the country, research was carried out to assess existing health promotion activities, and the opportunities and barriers for preventing non-communicable diseases (NCDs) in Cameroon. The research assessed four major NCD risk factors– tobacco smoking, excessive alcohol intake, lack of physical activity, and high fat/high salt content ‘Western’ diet. These were reviewed under health education; health protection (policy, legal or fiscal measures); and preventive medicine (interventions delivered largely by health professionals); ‘other’ interventions and monitoring/surveillance.
Findings of research
Key findings of the research suggested that there was no systematic monitoring of tobacco smoking, alcohol drinking and diet or physical activity levels in Cameroon.
Health promotion activity was limited. In addition, health protection measures were found to be weak or non-existent and even when present were often poorly enforced. Health education efforts were also minimal. There was almost no prevention through advice and support to people with risk factors for NCDs through primary health care services. Government strategies, if they existed, were limited and not supported by resources and the political will to ensure their effective implementation. Lobbying groups against tobacco and alcohol were found to be weak, whereas the industries were well-organised and powerful. The report was disseminated widely in Cameroon.
One of the main recommendations was:
“NCD prevention should be adopted as a public health priority with commitment to achieving tobacco and alcohol control and dietary and physical activity targets , through a cross-ministerial framework– not just in the Ministry of Health. Funding for NCD prevention also needs to be diversified outside of the Ministry of Health to Non-Governmental Organisations, other partners and civil society, in order to maximize sustainability.”
Considering the Cameroon context of limited health resources, low awareness about diabetes and multiple beliefs and practices that contradict prescribed conduct for the prevention of diabetes, a prevention approach was proposed.
Using advocacy supported by evidence, the government was led to develop and adopt a national diabetes policy, to bring about a more reliable supply of medicines at affordable prices to make screening and other diabetic needs cheaper, take over ownership of diabetic management and prevention approaches, and expand the programme to all the ten provinces of the country.
A tripartite prevention approach involving health facilities, the community, and the Ministry of health was used. At the health facility level diabetes clinics were created and staff trained to manage diabetes better and to carry out diabetes education and sensitization.
At the community level, community based organizations and traditional doctors were trained on the risk factors, signs, symptoms and the non pharmacological management of diabetes. Their role is to sensitize the population on diabetes. Traditional healers also identify and refer patients to the health facilities for screening. Large scale screenings are undertaken during major days like World Diabetes Day.
Following these, the government has since done the following:
- Elaborated and validated or adopted a national policy for diabetes
- Created a department for NCDs at the level of Ministry of Health
- Signed contracts with drug companies for affordable and reliable drug supply
- Incorporated diabetes drugs in the national essential drug supply system
- Reduced the cost of blood sugar test for diabetes
- Reduced cost of diabetes drugs
- Reduced cost of glucometers
- Expanded the diabetes clinics to all ten provinces in the country
Provided some equipment for diabetes and hypertension clinics