A Health care worker needs assessment to develop rural diabetic training workshops for diabetes and diabetic retinopathy screening in Kilimanjaro

Abstract

Background: A needs assessment was undertaken in Tanzania to identify what problems People With Diabetes (PWD) and their Health Care Workers (HCW) were facing, as preparation for a theory- and evidence-based intervention. In Tanzania only 1 out of 99 people with diabetes achieve good glycaemic control and Diabetic Retinopathy (DR) is common and the leading cause of preventable adult blindness.
Objective: The focus of the program was on improving self-management.
Methods: Intervention mapping was used to plan, develop, implement and evaluate a theory- and evidence based screening program for DR to prevent avoidable blindness.
Results: HCW demonstrated a poor knowledge of DR, treatment and the need for annual screening. Dietary
knowledge of HCW was poor and PWD did not rate them as good communicators. HCW understood the rational for PWD to take regular exercise but failed to recommend socially acceptable means of achieving this. HCW recognised that mental health issues such as anxiety and depression were hindering self-management and prevention of related complications and identified poverty as a key factor for PWD failing to undertake treatment regimens and self-manage their diabetes. Costs and a lack of resources was preventing good diabetes control. HCW recognised the need for diabetes training and resources with which to educate PWD.
Conclusion: The study highlighted the need for primary prevention of diabetes, with basic training for primary care focused on practical, local, and indigenous health challenges.
Key words: Diabetes, Diabetic retinopathy, Screening, Intervention mapping, Self-management