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25 April 2018
Community health workers assist diabetes control
Diabetes is hyperendemic in many countries and has already reached epidemic proportions in South Africa, where it is one of the leading causes of death. The epidemic has massive consequences for the national health system and places substantial financial burdens on individuals and families. Type 2 diabetes mellitus (T2DM) is the most common form of diabetes, occurring primarily as a result of obesity and lack of exercise, as well as genetic and environmental factors.

According to a study by researchers at UWC’s School of Public Health (SOPH), community health workers (CHWs) increasingly play key roles in supporting individuals to manage their disease successfully.

CHWs can assist diabetes disease control through education, support and advocacy. Typically, control of diabetes involves exercise and dietary changes, and regular monitoring of blood sugar levels.

The study was recently described in an article in the journal PLOS One entitled ‘Role of community health workers in type 2 diabetes mellitus self-management: A scoping review’. The SOPH researchers reviewed published research work in peer-reviewed articles produced from 2000 to 2015 on the worldwide use of CHWs to provide self-management support. Nearly all the studies involved research conducted in high-income countries and they suggest that, when well-coordinated, the roles of CHWs was found to be effective in controlling blood sugar and reducing diabetes complications.

The SOPH researchers found that education was the most common role of CHWs in supporting self-management of type 2 diabetes mellitus, followed by support, while advocacy was infrequently provided.

The study shows that CHWs are most effective in promoting disease control when they provide a combination of the education and support roles, rather than one of the functions on its own.

“The results of the study show that community health workers play significant roles in self-management of type 2 diabetes,” says Dr Bonaventure Egbujie, a PhD student from SOPH and the lead author of the study.

The study also found that CHWs were more effective in supporting disease management when individuals’ blood sugar control was poor. The researchers also found that CHWs who are directly linked to and supervised by a nurse are more effective than when supervised by another CHW or not supervised at all.

“Together, these findings show that in low-resource settings, CHWs can become a major bedrock of successful diabetes disease management,” Dr Egbujie says, “especially with adequate training and proper coordination.”

The researchers found wide variation in how CHWs are prepared to perform these functions and note that preparation plays a significant role in the success of CHW-led support programmes.

Study co-author and respected non-communicable disease expert, Professor Thandi Puoane adds, “Our research thus far has indicated the important role of CHWs in T2DM self-management. Preparing and coordinating community health workers for these roles are essential for success.”

The research study is part of the SMART2D (Self-Management and Reciprocal learning for the prevention and management of Type 2 Diabetes) project and was supported through a grant from the European Union Horizon2020 Programme. ‚Äč