Original Research

Current policies and practices for the provision of diabetes care and self-management support programmes for older South Africans

Mahmoud Werfalli, Katherine Murphy, Sebastiana Kalula, Naomi Levitt
African Journal of Primary Health Care & Family Medicine | Vol 11, No 1 | a2053 | DOI: https://doi.org/10.4102/phcfm.v11i1.2053 | © 2019 Mahmoud Werfalli, Katherine Murphy, Sebastiana Kalula, Naomi Levitt | This work is licensed under CC Attribution 4.0
Submitted: 12 February 2019 | Published: 29 August 2019

About the author(s)

Mahmoud Werfalli, Chronic Disease Initiative for Africa, Cape Town; and Department of Medicine, Division of Endocrinology and Diabetic Medicine, University of Cape Town, Observatory, Cape Town, South Africa
Katherine Murphy, Chronic Disease Initiative for Africa, Cape Town; and Department of Medicine, Division of Endocrinology and Diabetic Medicine, University of Cape Town, Observatory, Cape Town, South Africa
Sebastiana Kalula, The Albertina and Walter Sisulu Institute of Ageing in Africa, Cape Town; and Division of Geriatric Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa
Naomi Levitt, Chronic Disease Initiative for Africa, Cape Town; and Department of Medicine, Division of Endocrinology and Diabetic Medicine, University of Cape Town, Observatory, Cape Town, South Africa


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Abstract

Background: One of the most important primary health challenges currently affecting older people in South Africa (SA) is the increasing prevalence of non-communicable disease (NCD). Research is needed to investigate the current state of care and self-management support available to older diabetic patients in SA and the potential for interventions promoting self-management and community involvement.

Aim: This study aimed to review current policies, programmes and any other interventions as they relate to older people with diabetes with a view to assess the potential for the development of a self-management programme for older persons attending public sector primary health care services in Cape Town, South Africa.

Setting: Eighteen community health centres (CHCs) formed the sampling frame for the study.

Methods: This study aimed to review current policies and programmes as they relate to older people with diabetes. It involved a documentary review and qualitative individual interviews with key informants in the health services and Department of Health.

Results: Several national initiatives have sought to advance the health of older people, but they have only been partially successful. There are however multiple efforts to re-orientate the health-care system to focus more effectively on NCDs, which benefit older patients with diabetes. The establishment of community-based services to provide self-management support, promote health and ease access to medicine helps overcome many of the commonly cited barriers to care experienced by older patients. What may be equally important is that practitioners gain the communication skills and educational resources to effectively educate and counsel patients on lifestyle behaviour change and self-care management.

Conclusion: This article alerts policy-makers and clinicians to some of the specific issues considered to be pertinent and important in the care and management of older diabetic patients. Many of these would also be applicable to older patients with other chronic conditions.


Keywords

older patients with diabetes; diabetes care; diabetes self-management programmes; primary health care; South Africa

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