Global Effort on COVID-19 (GECO): Healthcare and socio-economic impacts of COVID-19 on patients with diabetes in Kenya and Tanzania

People with type 2 diabetes are among the population groups at risk of severe complications as a result of the pandemic. This project aims to explore the experiences of people with diabetes and healthcare providers in managing this type of diabetes during the COVID-19 crisis in Tanzania and Kenya. Type 2 diabetes is a long-term chronic condition that affects how the body processes blood sugar (glucose). For people living with type 2 diabetes, their bodies do not process insulin properly, resulting in unusual blood sugar levels which can be elevated. The symptoms include increased thirst, frequent urination, hunger, fatigue and blurred vision. In some cases, there may be no symptoms. Some important illness management practices include a healthy diet, exercise and medication including insulin therapy.

The COVID-19 pandemic resulted in disruptions in the health system. These impacted care for patients with chronic diseases that could result in poor illness management and negative health outcomes for people with diabetes due to psychological stress and poor access to healthcare due to economic hardship and limited social interaction. Country-specific evidence is needed on the real-life healthcare and broader socio-economic challenges experienced by people with diabetes and the healthcare system challenges during the COVID-19 pandemic. There is an urgent need to understand the health and socio-economic impacts of the COVID-19 pandemic on people with diabetes to inform policy and practice initiatives to strengthen health and social care systems and prevent poor health and socio-economic outcomes in this vulnerable population.
Through this study, we will explore the management of diabetes and the socio-economic well-being of people with diabetes in the context of COVID-19 in Kenya and Tanzania. Evidence from diabetes patients, service providers and policymakers will inform the national plans and policies responsive to the needs of diabetes patients during and after the COVID-19 pandemic.

Objectives
The primary objective of this study is to explore the experiences of people with diabetes in accessing healthcare and related socio-economic services before and during the COVID-19 pandemic in selected rural and urban areas in the two countries.
Specifically, the study seeks to:

1. Determine the level of awareness and knowledge of COVID-19 among people with diabetes.
2. Assess the attitude and acceptability of the COVID-19 vaccine among people with diabetes by identifying factors that determine acceptability approaches for improving vaccine uptake among people with diabetes.
3. Explore challenges experienced by people with Type 2 diabetes in accessing healthcare and socio-economic services before and during the COVID-19 pandemic.
4. Identify common localized practices/remedies used to manage COVID-19 by people with diabetes.
5. Estimate the economic burden of COVID-19 for individuals with diabetes.
6. Explore health care providers’ perspectives on managing diabetes during the COVID-19 crisis.
7. Identify policy gaps in the management of diabetes during COVID-19.
8. Develop health recommendations and action plans for supporting self-management of diabetes

PARTNER INSTITUTIONS

• Ifakara Health Institute, Tanzania
• African Population and Health Research Center, Kenya
• University of Glasgow, UK

PARTNER MEMBERS

• Project advisors: Dr. Victor Kibe, Nairobi County  NCD Division HoD

PROJECT PERIOD

• The project duration is 18 months from September 2021. The project will be implemented in Tanzania (Morogoro and Dar es Salaam) and Kenya (Nairobi, Kiambu, Nyeri and Vihiga).

PROJECT FUNDERS

• The project is funded by the UK Research and Innovation (UKRI) and Medical Research Council (MRC) through the Global Effort on COVID-19 (GECO) health research.

PROJECT TEAM

• Gershim Asiki
• Richard Sanya
• Peter Kibe 
• Shukri Mohamed
• Caroline Karugu
• Florence Sipalla
• Michelle Mbuthia
• Musumba Allan