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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Managing type 2 diabetes in Soweto-The South African Chronic Disease Outreach Program experience
Primary Care Diabetes, Volume 3, No. 3, Year 2009
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Description
Diabetes (DM) and its resultant complications are a problem worldwide, and especially in developing countries like South Africa (SA). Risk factors associated with DM are potentially modifiable, but DM control is poor. Problems in SA include high prevalence of morbidity from DM and hypertension (HTN), lack of recognition of the importance of chronic kidney disease (CKD), late presentation to health care services, lack of education of health providers and patients, and poor quality of care in primary health care settings (PHC). In response, there has been growing advocacy for prevention strategies and improved support and education for primary health care nurses (PHCNs). A Chronic Disease Outreach Program (CDOP), based on the chronic care model was used to follow patients with DM and HTN, support PHCN, and improve health systems for management in Soweto. A group of 257 DM patients and 186 PHCN were followed over 2 years, with the study including the evaluation of 'functional' and clinical outcomes, diary recordings outlining program challenges, and a questionnaire assessing PHCNs' knowledge and education support, and the value of CDOP. CDOP was successful in supporting PHCNs, detecting patients with advanced disease, and ensuring early referral to a specialist center. It improved early detection and referral of high risk, poorly controlled patients and had an impact on PHCNs' knowledge. Its weaknesses include poor follow up due to poor existing health systems and the programs' inability to integrate into existing chronic disease services. The study also revealed an overworked, poorly supported, poorly educated and frustrated primary health care team. © 2009 Primary Care Diabetes Europe.
Authors & Co-Authors
Katz, Ivor J.
South Africa, Johannesburg
University of the Witwatersrand
Schneider, Helen
South Africa, Johannesburg
Wits School of Public Health
Shezi, Zodwa
South Africa, Johannesburg
University of the Witwatersrand
Mdleleni, Golebemang
South Africa, Johannesburg
University of the Witwatersrand
Gerntholtz, Trevor E.
South Africa, Johannesburg
University of the Witwatersrand
Butler, Omar
South Africa, Johannesburg
University of the Witwatersrand
Manderson, Lenore H.
Australia, Clayton
Monash University
South Africa, Johannesburg
Wits School of Public Health
Naicker, Saraladevi
South Africa, Johannesburg
Charlotte Maxeke Johannesburg Academic Hospital
Statistics
Citations: 54
Authors: 8
Affiliations: 4
Identifiers
Doi:
10.1016/j.pcd.2009.06.007
ISSN:
17519918
Research Areas
Health System And Policy
Noncommunicable Diseases
Study Design
Cross Sectional Study
Study Locations
South Africa