Improving the lives of diabetics in Nairobi's slum through access to quality health care
The objectives of the study were as follows:
· Improve the capacity of primary health care level facilities serving three Nairobi slums to offer services for chronic diseases which are in line with the level of expertise available at these facilities.
· Improve the skills of health providers in the management of diabetes and other comorbidities with emphasis on the use of integrated guidelines and patient empowerment.
· Strengthen the linkages between the public and private sectors in health by harnessing resources from both sectors and complimenting each other's strengths in providing care for diabetes and its co-morbidities.
· Enhance community capacity to respond to diabetes through creation of patient and family support groups.
· Generate evidence to support the allocation of resources (especially drugs) to primary level health facilities for the management of chronic diseases while providing hands-on training opportunities for undergraduate medical, nursing and clinical students in diabetes care that emphasizes use of integrated guidelines and patient empowerment.
These objectives were to be achieved by the following activities:
· Setting up and running outreach clinics for patients with DM & HPT in three slums (Korogocho, Viwandani, Dandora).
· Building capacity of health workers in 15 HF to screen, diagnose and manage DM & HPT. This was to involve training of health workers and provision of equipment.
· Generating evidence of the impact on the quality of life and lifestyles of clinic attendees.
· Community sensitization via free medical camps, distribution of IEC materials and media programs.
· 17 health facilities (11 public and 5 private) were equipped with basic but essential diagnostic equipment for diabetes and hypertension.
· 27 clinical officers trained; 54 nursing staff trained and 36 community health workers and paramedics trained.
· Partnership established which brought together; DMI, NWB, Provide International and CAFKID (private) and CCN, Mbagathi district hospital (public).
· Patients support groups formed and 30 members trained as expert patients and as trainers of trainers on self-monitoring and management of diabetes and hypertension.
· 11 medical camps in total conducted (5 in Korogocho; 5 in Viwandani and 1 in Dandora).
1 dissemination with policy makers held plus numerous media coverage in both print and electronic media.
Version 1.0, February 2015. With anonymised datasets and study materials added.
Korogocho and Viwandani informal settlements in Nairobi
Unit of Analysis
Producers and sponsors
Authoring entity/Primary investigators
African Population and Health Research Center
World Diabetes Foundation
The study communities (Korogocho and Viwandani)
Staff of APHRC
Provide International, Nutritionists Without Borders (NWB)
Care and Advocacy for Kidney Disease (CAFKID)
City Council of Nairobi (CCN)
Diabetes Management and Information Center (DMI)
Mbagathi District Hospital
Dates of Data Collection (YYYY/MM/DD)
Mode of data collection
Research assistant was responsible for data quality control through spot-checks, sit-ins and office editing of questionnaires. Research assistance reported to research officer.
Type of Research Instrument
For each questionnaire, provide a summary on the main sections, target population (population and clinic)
Baseline questionnaire: all patients attending clinics. It list patients' demographic identifiers (respondentID, age and sex), history of medical conditions and treatment, lifestyle history as well as clinical and anthropometric measurements.
6 months follow up: all patients attending clinics. As above.
One year follow up: all patients attending clinics. As above.
Clinic cards: all patients attending clinics. Routine recording of patients clinical and anthropometric measurements.
Head Statistics and Survey Unit
All non-APHRC staff seeking to use data generated at the Center must obtain written approval to use the data from the Director of Research. This form is developed to assess applications for data use and facilitate responsible sharing of data with external partners/collaborators/researchers. By entering into this agreement, the undersigned agrees to use these data only for the purpose for which they were obtained (as outlined on this form) and to abide by the conditions outlined below:
1. Data Ownership: The data remain the property of APHRC; any unauthorized reproduction and sharing of the data is strictly prohibited. The user will, therefore, not release nor permit others to use or release the data to any other person without the written authorization from the Center.
2. Purpose: The provided data must be used for the purpose specified in the Data Request Form; any other use not specified in the form must receive additional or separate authorization.
3. Respondent Identifiers: The Center is committed to protecting the identity of the respondents who provide information in its research. All analytical data sets (both qualitative and quantitative) released by the Data Unit MUST are stripped of respondent identifiers to protect the identity of the respondents. By accepting to use APHRC data, the user is pledging that he/she will not, under any circumstance, regenerate the identifiers or permit others to use the data to learn the identity of any individual, household or community included in any data set.
4. Confidentiality pledge: The user will not use nor permit others to use the data to report any information in the data sets that could identify, directly or by inference, individuals or households.
5. Reporting of errors or inconsistencies: The user will promptly notify the Head of the Statistics and Survey Unit any errors discovered in the data as soon as the errors are discovered.
6. Publications resulting from APHRC data: The Center requires external collaborators to work with APHRC staff on all publications resulting from its data. In order to facilitate this, lead authors should send a detailed concept note of the paper (including the background, rationale, data, analytical methods, and preliminary findings) to the Principle Investigator (or Theme Leader) for the project (with a copy to the Director of Research), who will circulate the abstract to concerned researchers for possible expression of interest in participating in the publication as co-authors. Any exception to the involvement of APHRC staff should be approved by the Director of Research, APHRC.
7. Security: The user will take responsibility for the security of the data by ensuring that the data are used and stored in a secure environment where access is password protected. This will ensure that non-authorized people should not have access to the data.
8. Loss of privilege to use data: In the event that APHRC determines that the data user is in violation of the conditions for using the data, or if the user wishes to cancel this agreement, the user will destroy the data files provided to him/her. APHRC retains the right to revoke this agreement or informs publishers to withhold publication of any work based wholly or in part on its data if the conditions for using the data are violated.
9. Acknowledgement: Any work/reports from this data must acknowledge APHRC as the source of these data. For example, the suggested acknowledgement for NUHDSS data is:
"This research uses livelihoods data collected under the longitudinal Nairobi Urban Health and Demographic Surveillance System (NUHDSS) since 2006. The NUHDSS is carried out by the African Population and Health Research Center in two slums settlements (Korogocho and Viwandani) in Nairobi City."
Additionally all funders, the study communities that provided the data, and staff who collected and analyzed or processed the data should be acknowledged.
10. Deposit of Reports/Papers: The user should submit electronic and paper copies of all publications generated using APHRC data to the Policy Engagement and Communications Department, with copies to the Director of Research.
11. Change of contact details: The user will promptly inform the Director of Research of any change in your personal details as contained on this data request form.
African Population and Health Research Center, Improving the lives of diabetics in Nairobi's slum through access to quality health care, February 2015.APHRC, Nairobi, Kenya. doi:11239/176-2014-027-1.0
Disclaimer and copyrights
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.