MICHAEL IDAH, the country director and secretary general of the Christian Health Association of Nigeria, (CHAN), has years of experience in public health, disability inclusion and community development administration. In this interview with IFEOMA OKEKE, he speaks on measures Nigeria can take in reducing the rise in diabetes cases.
In 2014, it was estimated that 8.5 percent of adults aged 18 years and older had diabetes globally and it is predicted to rise to 10.2 percent by 2030, globally. What do you think are the reasons for the increase in numbers?
I would say late diagnosis, and the high costs of healthcare are the primary drivers for the spike in global diabetes cases. As with many non-communicable diseases, early detection is vital in ensuring proper management. The rise in diabetes cases is further compounded by the low standard of living in developing economies, which affects lifestyle choices and ability to pay for medical care in the eventuality of disease. Unhealthy lifestyles and poor dietary habits cannot be overemphasized. Quality healthcare is first a personal responsibility before it is an obligation for the healthcare professional.
Eating a balanced diet, engaging in physical exercises, taking necessary rest and routinely visiting the hospital for check-ups are proactive measures everyone should observe. When all these precautionary measures are lacking, and people with diabetic tendencies fail to seek medical attention early, the consequences can be dire.
A case in point is Nigeria. The current economic indices and inflation contribute to the rising cost of healthcare, which makes the cost implications of diabetes care management a huge cause for concern, particularly for vulnerable groups, like populations in rural areas. Because diabetes care is a lifelong responsibility that can be relatively expensive to manage, from our experience, the high cost of managing diabetes usually results in people opting not to seek medical attention.
To address diabetes in Nigeria, it is believed that every sector/individual has a role in accomplishing this goal. How do you see this playing out?
You are correct. Addressing the burden of diabetes requires a concerted, multi-dimensional and multi-stakeholder approach. We might stand a chance at addressing diabetes when all relevant stakeholders efficiently deliver their core duties at the different stages of diabetes care. This encompasses people living with diabetes, their loved ones, who encourage them to keep going, community health workers, health training institutions, private organizations, international health organizations and local non-governmental organizations like The Christian Health Association of Nigeria, (CHAN).
Organisations like CHAN and Novo Nordisk, have established partnerships to ensure quality diabetes treatment and care are made available and affordable for people in need of diabetes care. Healthcare providers are responsible for diagnosis and administering quality care while the government has the core duty to enforce health policies and the provision of healthcare facilities. The media, also, is a crucial stakeholder in creating awareness and educating the public on diabetes care.
When the huge demand for diabetes care is juxtaposed with the current national economic situation, it becomes clear that as a society, we all have complementary roles to play in creating awareness and ensuring treatment services are available and affordable to persons living with diabetes.
As diabetes and other non-communicable diseases continue to rise, achieving universal healthcare coverage in Nigeria is crucial now more than ever
According to a report by the World Health Organisation (WHO) in 2018, non-communicable diseases prevalence in Nigeria stood at 29percent, Cardiovascular diseases at 11 percent, Cancer 4 percent and Diabetes two percent. So, what are faith-based networks like the Christian Health Association of Nigeria, (CHAN) doing to address diabetes and other non-communicable diseases in Nigeria?
At the CHAN, we primarily coordinate all the Christian health institutions in Nigeria. Our network currently spans 600 facilities across Nigeria. We have a mission to provide quality healthcare to all Nigerians in an efficient and collaborative way. For this reason, we partner with various agencies and donor organizations that are aligned with our mission. These entities provide funding and diagnostic equipment to cater to people in need of healthcare services. We have also been able to provide subsidized healthcare products, through our partnerships with pharmaceutical organisations for distribution and warehousing services.
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CHAN is also engaged in providing capacity development, by facilitating professional training for healthcare service providers. We also ensure that up-to-date, state-of-the-art diagnostic facilities are readily available to institutions that provide these services. Our activities also cover creating mass awareness about non-communicable diseases like diabetes, through various media like community awareness programmes, town halls, and traditional and non-traditional mass media channels – including print.
In adding value to the ecosystem, we engage in operational research, with the end goal of providing recommendations to improve services in the health sector. Above all, as a faith based organization we ensure that we share the love of God in the delivery of our services.
What success stories has CHAN recorded over the years in the fight against diabetes in Nigeria?
We have recorded quite a few milestones over the years. In 2018, CHAN began a partnership with Novo Nordisk on its Base of the Pyramid (BoP) project to improve access to quality diabetes care and affordable treatment for people living with diabetes within the faith-based network. Through this partnership, healthcare professionals in over 70 faith-based facilities in Nigeria have been trained in diabetes management. We have seen improvements in the capacity to manage diabetes; from faith-based facilities initiating diabetes clinics to improve service delivery, to patients establishing informal peer groups to create a sense of belonging as part of the psychosocial support people living with diabetes need.
For us at CHAN, raising awareness about chronic conditions in the rural communities where many faith-based hospitals are located has always been our focus. We have facilitated community diabetes awareness and screening campaigns across five states in Nigeria, reaching over 1,000 people in these efforts. In addition to providing faith-based facilities with glucometers and testing supplies also supported by Roche Diabetes Care.
At the peak of the COVID-19 pandemic, our partnership with Novo Nordisk allowed us donate personal protective equipments and infection prevention and control materials to 15 faith-based facilities in order to help protect our healthcare workers as they responded to the pandemic and continued to provide emergency care for people living with diabetes and other non-communicable diseases.
Despite some of the challenges that are brought on by a pandemic, we remained adaptive alongside our partners. In the BoP project, we continued building the capacity of healthcare professionals via virtual platforms to improve their ability and confidence to manage diabetes and support patients in the context of COVID-19.
What deliberate efforts do you think the government can make in the fight against diabetes and other non-communicable diseases in Nigeria?
Intentionality and consistency in providing quality healthcare and essential medicines for all Nigerians is important. As diabetes and other non-communicable diseases continue to rise, achieving universal healthcare coverage in Nigeria is crucial now more than ever. This will involve the government optimizing the national health insurance scheme so that every Nigerian, across all socio-economic classes can access quality healthcare.
Genuine collaboration with healthcare providers will aid the government in leading service delivery. Creating awareness about non-communicable diseases and supporting the dissemination of adequate information can make a difference in the prevention and control of non-communicable diseases.
For mission institutions like CHAN, support can be provided in employing and posting qualified medical professionals to partner healthcare facilities, to augment our efforts in developing the health sector.
Considering your experience and activities supporting people living with diabetes, how do we leverage cross-sectoral partnerships to enhance the support for people living with diabetes?
Partnerships are very critical and collaboration across cross-sectoral lines brings the strength in diversity to bear for innovation. Like I mentioned, these partnerships require all hands – from family and friends to private, government and non-governmental organisations.
For example, insights from the operational research I mentioned, suggest that persons living with diabetes face a level of stigmatisation. The rigours of treatment, the food and lifestyle restrictions placed on diabetes patients often create an emotional strain. Thus, the provision of psycho-social support is needed across board to address the social stigma. Family and friends can provide this support and ensure adherence to treatment.
The community must also engage with all platforms for communication to create diabetes awareness and debunk false opinions on the disease. Government and private sector stakeholders should engage to ensure patients have access to quality and affordable diabetes care and treatment.
With the right structures and collaboration, we can share the burden and help people living with diabetes achieve an improved quality of life.
