A national diabetes care and education programme: the Ghana model

An account is given of how a national diabetes care and education programme was developed in Ghana, a developing country, through international collab oration of medical schools, industry and government health cars institution s. The approach is by way of trained diabetes teams consisting of physician s, dietitians and nurse educators at two tertiary institutional levels (tea ching hospitals) who in turn trained teams consisting of physicians, dietit ians or diettherapy nurses, nurse educators and pharmacists at regional and district/sub-regional levels to offer care and education to patients and t he community. In three years all regional and about 63% of sub-regional/dis trict health facilities had trained diabetes health care teams, run diabete s services and had diabetes registers at these institutions. Additionally a set of guidelines for diabetes care and education was produced. All progra mme objectives with the exception of one (deployment of diabetes kits) were met. Distances to be travelled by persons with diabetes to receive diabete s care had been reduced considerably. The success of the project has given an impetus to the collaborators to extend the programme to the primary heal th care level. The continuing prohibitive prices of diabetes medications an d supplies however, could be addressed by removing taxes on such supplies. The Ghana diabetes care model, a 'top-down' approach, initially involving t wo diabetes centres is recommended to other developing countries, which int end to incorporate diabetes care and education into their health care syste m. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.