Diabetes, Control, Care & Support (DCCS) Program

KARUCAN Foundation started the Diabetes program in 1999 under the Primary Health Care (PHC) Community & Home-based integration Service Delivery mechanism, under Public-Private Partnership for Health (PPPH) of the Ministry of Health through the District Health Office of Kasese District Local Government to strengthen the National, Regional & District & Community diabetes response by addressing gaps in diabetes awareness, diagnosis, care, and management.

Justification:

Since 1999, most rural districts of Uganda have faced challenges in the delivery and quality of diabetes care. People with diabetes often lack access to insulin, and when available, it costs $8 or more during stockouts. Additionally, they travel long distances to access diabetes care services. Limited access to diabetes specialists and multidisciplinary treatment further compromises the quality of diabetes management. These issues have increased diabetes-related morbidity and mortality in the region and the country at large.

According to the International Diabetes Federation (IDF), as of 2021, an estimated 716,000 adults in Uganda had diabetes, representing a prevalence of 3.6% among the adult population. About 89% of Ugandans with diabetes are neither on medication nor aware of their status, leading to complications. By 2024, 9.7 million adults have undiagnosed diabetes, 29.3 million have diagnosed diabetes, and 115.9 million have pre-diabetes.

The IDF projects that the number of people with diabetes in Uganda will increase significantly by 2025, with a doubling of prevalence in rural areas. The total number of people living with diabetes is projected to rise to 643 million by 2030 and 783 million by 2045.

Economic Burden of Diabetes in Uganda:

Diabetes costs the Ugandan Government and households UGX 2.2 trillion annually. With a prevalence of 4.1% for all types of T2DM in 2019, 1.69 million Ugandans have T2DM. Managing and treating T2DM is costly, with oral drugs and OPD consultations being key cost drivers. Diabetic eye treatment, hemodialysis, and strokes drive high costs for T2DM-related complications. Emphasis must be placed on spreading knowledge about T2DM and developing prevention programs.

KARUCAN Foundation's Role:

Given the above challenges, KARUCAN Foundation seeks external grant funding and support from donors and well-wishers to support its Diabetes, Control, Care, and Support Program. The program focuses on the following activities:

1. Care: Focus on primary level care as the first point of contact with the healthcare system. Training healthcare professionals for accurate diagnostics and early detection of diabetes to prevent complications.
2. Advocacy: Raising the priority of diabetes/NCD prevention and control within global, regional, and national agendas. KAFO engages in advocacy and stakeholder mobilization.
3. Partnership - Integrated Care: Ensuring people living with diabetes and other NCDs receive a full continuum of health care, including health promotion, disease prevention, diagnosis, treatment, and management.
4. Diabetes Prevention: Targeting childhood, adolescence, and women of reproductive age. Promoting healthy environments and interventions during pre- and post-partum stages.
5. Diabetes Prevention/Control & Care (DPC) through School Programming: Implementing primary prevention initiatives in schools, promoting healthy lifestyles, and educating students, teachers, and parents about diabetes.
6. Conduct Research: Training health workers in evidence-based diabetes care and research, and monitoring and evaluation activities.
7. Promoting Digital Health Care: Empowering health professionals to use digital health care technology in diabetes prevention, control, and care.
8. Referral Care Services: Referring people with diabetes to appropriate facilities.
9. Regional/District Response to Diabetes Control & Care: Establishing a well-equipped Regional Center for Diabetes Control & Care (CDC) to serve six rural districts in the Rwenzori Sub Region.

Program Impact/Result-Based Indicators:

• At least 6,000 people reached and empowered about diabetes prevention/control.
• Number of students, parents, and teachers trained as peer educators in diabetes prevention.
• Number of people sensitized on diabetes risk factors, signs, symptoms, complications, and prevention.
• Number of school food gardens established in 100 schools.
• Number of people reached by TV programs, media campaigns, and other diabetes awareness activities.
• Number of reports published.
• Number of diabetes support groups established and functioning.
• Number of integrated supportive supervision for facility-based health service quality conducted.
• A well-equipped and functional KARUCAN-CDC established in the Rwenzori Sub Region.
• Number of regional NCD intersectoral coordinating mechanisms established.
• Number of clients receiving specialized diabetes care services from KARUCAN-CDC.
• Number of baseline and end-line KAP surveys/community needs assessments conducted.