Sunday, 21 April 2013

THE DYNAMICS OF DIABETES CARE IN A DEVELOPING WORLD


INTRODUCTION

    According to the international Diabetes Federation diabetic Atlas; Diabetes Mellitus is one of the most common non-communicable diseases (N.C.D) globally.
D.M, is the fourth leading cause of death in most high-income countries and now there is substantial evidence showing that it is epidemic in many economically developing and newly industrialized countries.

     Africa, a multicultural, religious and ethnically diverse continent had traditionally been dominated by infectious diseases but with rapid urbanization, NCD’s are quickly becoming a priority for health in this continent; with an estimate of about 14.7 million Adults being diabetic in 2011 and a projection of 28.0 million by year 2030.
     According to I.D.F, financial estimate of Africa indicate that at least USD2.8billion was spent on health care due to diabetes alone in 2011 and this is expected to rise by 61% in 2030. It is however imperative, based on the facts above as health care givers and stakeholders to firstly understudy Africa with its peculiarities and strategize a befitting and appropriate health care system that put into consideration and accommodates the African mindset.
This health care system must understand Afric’s multicultural settings,religious inclinations and embrace its ethnic diversity.

FACTORS AFFECTING DIABETIC CARE AND POSSIBLE SOLUTIONS

Africa, a developing continent is characterized by multiple factors that has plunged the continent into an era of economic and social setbacks and this has slowed down the rate of health care delivery in the continent.
Factors influencing African health care delivery noteworthy include:

1)  RELIGION
         Vast majority of Africans anchor their belief to A Supreme Being who is held in the highest esteem with instructions and guidance being handed over through HIS representatives to the followers. These representatives are called clergy. African religious setting is multifaceted and has been a great influence on lifestyle and philosophy. Some believe diseases and ailments serve as a punishment for wrongdoing or an attack.
   The role of religion in diabetic care cannot and must not be underestimated as it plays a major role in the attitude of individuals and the community to diabetic care. In view of this, community diabetology should be encouraged with individual communities coming up with programs that put into consideration religious beliefs perculiar to such community.
Diabetic education and enlightenment should also be integrated into all religious institutions.
                     
Community Diabetes Awareness

2)   EDUCATION
According to UNESCO Africa fact sheet:
176 million Adults are unable to read to write.
47million youth (age 15-24) are illiterates.
21millions adolescents are out of school and 32 million primary aged children are not in school.

The fact above reflects a continent with poor educational foundation for both the adults and the youths (future leaders). Education is paramount to information dissemination and economic Growth
International design of diabetic care and education should be revisited with the inclusion of more flexible and grass root friendly Programs. To an average uneducated African, “the absence of disease is Health” as against the W.H.O Definition of Health and this mentality coupled with cultural and religious belief system on disease affect preventive medicine in Africa.
      To a large extent, people don’t tend to complain until they start noticing complications; this added to the silent nature of D.M results in the highly complicated D.M found at hospitals.

3)   CULTURE
       African culture is varied and diverse. With the introduction of westernization, Africa’s age long culture and traditions are being substituted for western styles. This with urbanization has to a greater extent made Diabetic Care progressive in Africa i.e. through the media, internet, community research and community screening.
      In light of these remarkable progress; styles, trends and culture that promotes preventive care in diabetic health care should be considered in Africa
 


Free Community Diabetic Screening Conducted by Students Of Olabisi Onabanjo University Teaching Hospital,Sagamu,Ogun State,Nigeria

4)   POVERTY
        According to a UN report-

Half of the population of Africa lives below a dollar a day.
32 of the world’s 38 heavily indebted poor countries are in Africa (World Bank).
Slums are homes to about 72% of urban citizens.

These alarming facts reflects a continent where half of its population can’t boast of good feeding habits, good social status and most importantly access to quality health.
Procurement of drugs and the ability to afford healthy diets are difficult by people who live below a dollar a day. Hence, diabetic care should involve Philanthropists, Non-Governmental organizations, Societies, Governments and pharmaceutical companies who through serious effort and commitment would empower the continent economically.
    Also, I.D.F through its national bodies in Africa and affiliates should engage government into subsidizing drugs to make them affordable, available and extremely cheap such that majority of the African populace can have access to it and afford it. This will make life easier for those suffering extreme hardship in Africa


    Finally, it is imperative I point our attention to a silent but serious issue in Africa: Medical ethics and trado medical ethics.
    Africa, unlike many developed continents where rules and regulations guide healthcare delivery system is faced with a challenge. The trado medicals (groups of people that use herbs in treating medical conditions) are generally not well structured and not aligned with the medical professionals. This has for a long time been a major issue of contention with people being deceived in the ability of a single drug to cure all ailments in existence. ‘Gbogbonise’ – A drug for all ailments as it is called, has been largely marketed and sold amongst the uneducated in the community,with even a small fragment of the educated patronising them giving false hopes of a permanent cure to D.M and this has accounted for high percentage of late presentation at the hospitals.
      To forestall these activities, it is important to involve, train, and educate the tradomedicals on diabetic care and this I strongly believe, will go a long way in stopping the menace constituted by late presentations at clinics.
 In addition, a structure can be put in place by the African government and leaders for the tradomedicals which will spell out the ethics of their profession and limit the unprofessionalism demonstrated in the community.



Various Tradomedical Schemes At Marketing Drugs in Nigeria

In conclusion, the peculiarity of the African continent requires calls for a more radical and strategic approach in diabetic care with health care givers, researchers, government, and NGO’s understanding the challenges posed by the factors and putting these into consideration in developing a plan in diabetic health care delivery for the continent.


REFERENCES
 IDF Diabetic Atlas (5th Edition)
uis.unesco.org
achieveinafricawordpress.com
articlebase.com
africanlibraryproject.org


Adejumo Hakeem
hakeem_adejumo@yahoo.com

From the IDF africa Newsletter 2nd edition

5 comments:

  1. Diabetes is a very tough disease to care for. You have to make huge changes in your diet and also carefully monitor and maintain your disease.



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