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Running a paediatric diabetes programme in a

resource limited country: is it rewarding


E.S. Majaliwa, K.C. Muze, R. Kaushik, E. Licoco, Z. Ngoma &
G. Kagaruki

Presenter Disclosure Information

[EDNA SIIMA MAJALIWA]


No conflict of interest to declare.

Country location
Total area 945,090 sq km
(364,900sq miles)

located in
East Africa

Population:
45millions (2010)
0 -14 yrs: 44%
15 - 64 yrs: 53%
> 65 yrs: 3%

Per capita income, (current US$)350.0


Death rate: 16.75 deaths/1000 population

Population growth;
2.5 % annually
Life expectancy at birth;
51.9 years
Literacy rate;
(% of females 15-24Yrs)
76.2 %

INTRODUCTION
Effective monitoring important to childrens health
Failure of which will lead to premature complications and
deaths; especially when children are vulnerable to
socioeconomic
Tanzania Diabetes Association launched a programme in
2005 under IDF Child Sponsorship program aiming at
providing care for children with T1DM at Muhimbili National
WDF joined hands to start TUNZA WATOTO progrmme in 2007
In 2011 the TUNZA WATOTO Project changed to CDiC with
additional of more clinics

AIM
Looking at the programme we took an
audit aiming at
Assessing the outcomes of access to care for
children with T1DM.

METHODS
Retrospective assessment was conducted
at the MNH in 2011 and in 2013 other
hospitals.
The assessment involved data auditing,
medical records, and routine reports.

WHAT HAS BEEN ACCESSED


Insulin
Glucose and Urine monitoring
Health care providers with knowledge on
Diabetes at different levels
Various interventions for sensitization in the
community and schools.

Results
Preliminary results of the project are very
positive.
Increased number of enrollelment as well as
the clinics throughout the country.
From just one paediatric clinic to 33 clinics
throughout the country
From 30 children in 2005 to 1300 children

2005 to date
NUMBER OF CHILDREN
1400

1200

1000

800
NUMBER OF
CHILDREN

600

400

200

0
2005 2008 2009 2011 2012 2013 2014

TANZANIA

GLYCAEMIC CONTROL
HbA1C-TREND

FOLLOW UP ON HbA1c

16

YEAR

HbA1C
7.5%

8-10.5

11->14

TOTAL

2008

5
(7.8%)

13
(20.3%)

46
(71.9%)

64
(100%)

2009

5
(8.3%)

12
(20.3%)

43
(71.7%)

60
(100%)

0.000

63
(26.1%)

120
(49.8%)

241
(100%)

0.000

14

12

10

P.
VALUE
0.05
0.000

HbA1C

2012/13 58
(24.1%)

TOTAL
18.6%

0
2005

2008

2009

2012/13

24.1%

57.3% 100.0%

OTHER ACHIEVEMENTS

Normal school attendance


Microfinance projects
Peer Educators
Vocational training
programs have become a teaching model
for nurses, doctors from in and outside
Tanzania
Awareness campaigns

PEER EDUCATION, SCHOOL PROGRAMMES AND AWARENESS CAMPAIGNS

Example of one family in the Microfinance project


Name of child: CC(12 yrs)
Diagnosed: 2005
Business plan: Brick making for building sites
Savings pledged per month: 10,000 Tshs (10 USD) or more
depending on how many bricks sold

(b)

(a)

(c)

Started an adolescent programme, may be will


help to sort out the adolescents problems and
hence improve the HbA1C

CONCLUSIONS
These achievements shows that:
Despite being a limited resource country,
great commitment from programmes and
efforts to improve care can bring positive
results and improve the quality of life.

IT CAN BE DONE, TOGETHER WE CAN

THANK YOU FOR YOUR ATTENTION

Welcome to Tanzania,