In June and August 2019, researchers from the Liverpool School of Tropical Medicine (Shabbar Jaffar, Hazel Snell, and Joseph Okebe) and ISGlobal (Jeffrey Lazarus and Camila Picchio) traveled to Uganda and Tanzania to visit some of the clinics where the European Commission-funded INTE-AFRICA project will initiate a cluster randomized controlled trial in January 2020. The overall goal of the project is to scale up care for diabetes and hypertension in the two countries. The project is testing the efficacy and acceptability of integrating diabetes and hypertension services alone, or in combination with HIV-infection services. The study’s pilot project, Management of Chronic Conditions in Africa (MOCCA), which was funded by NIHR and where integration was piloted in 10 clinics (5 in Uganda and 5 in Tanzania), is coming to an end and lessons learned will be applied to INTE-AFRICA.
Scaling up care for diabetes and hypertension will require integration into primary care, which presents a challenge given that health services coverage remains low in the two countries. It is said that less than 5% of people with diabetes or hypertension are thought to be receiving care in sub-Saharan Africa as a whole.
During the visits to Tanzania and Uganda, the researchers met with partner institutions including The AIDS Support Organisation Uganda (TASO Uganda) and the Ministry of Health of Uganda in addition to the Medical Research Centre/Ugandan Virus Research Institute/London School of Hyigene and Tropical Medicine and the National Institute for Medical Research- Muhimbili Centre and Shree Hindu Mandal Hospital in Tanzania.
The purpose of the trips was twofold: to meet with partner institutions to examine the progress of the study, but also to discuss a crucial component of the research: the communications materials. Specifically, dialogues on how to develop culturally and language appropriate diabetes and hypertension posters and leaflets were held in both countries, receiving input from the partner institutions as well as patients, healthcare workers, study team members, and social scientists. The posters will be hung up in the health clinics and the leaflets distributed to patients to provide health information for years to come so it was crucial for the study team to understand the communications materials that are needed for the project. This was done through discussions but also by evaluating and learning what material is already available in both countries and discussing with patients and healthcare workers about what they would like. Variables to consider while developing communications material for global health projects vary from colour palette, amount of text and illustration style to size and material durability that can withstand extreme temperatures.
Current diabetes management material can be found written on White boards in clinics (Ndejje Health Centre IV, Uganda)
Uganda site visits:
- Kiswa Health Centre III, Mbuya (Kampala)
- Wakiso Health Centre IV, Wakiso
- Ndejje Health Centre IV, Kibiri (Kampala)
Tanzania site visits:
- Ya Rufaa Ya Mkoa Ya Amana Hospital, Dar es Salaam
- Shree Hindu Mandal Hospital, Dar es Salaam
