Located in the Indian Ocean, the Union of the Comoros remains among the poorest countries in the world. The coverage of health professionals is very low, with only 1.9 doctors on average per 10,000 inhabitants and barely 2.6 nurses per 5,000 inhabitants.
This low coverage still does not allow today to provide the population with sufficient health services, in particular for noncommunicable diseases (NCDs) which have become an epidemiological burden throughout the country, with the example of diabetes which now affects almost 5% of the population.
Santé Diabète started its field actions in the Union of the Comoros in 2015.
The assessment of the situation in 2015 highlighted an alarming situation which, thanks to the needs analysis, enabled us to define our priorities for action to improve the care and access to treatment for people with diabetes in the country:
- Geographic and financial accessibility to diabetes care
- Availability of drugs, consultation and analytical materials
- The number of health professionals trained to manage diabetes
- Actions to prevent diabetes risk factors
- Organizing the health system to adapt it to the management of chronic diseases
Based on the experience developed in Mali and Burkina Faso, Santé Diabète has set up a structuring program with a global approach including all the axes necessary for the implementation of quality diabetes prevention and care.
strengthening human resources
access to drug
strengthening technical platforms and biological assessments
the development of prevention and therapeutic education programs
support for the structuring of diabetic patient associations locally, regionally and nationally.
Our support for the national strategy to fight diabetes in the Union of the Comoros has made it possible to obtain important results for the Ministry of Health and Solidarity as well as for people with diabetes on the 3 islands of the country.
Strengthening national policy documents
- Support for the drafting of a national strategic framework for combating diabetes in the Union of the Comoros.
- Organization by Santé Diabète of a study visit to Mali to allow sharing of experiences with partners in the fight against diabetes.
In connection with the Ministries of Health, we have implemented many activities allowing better prevention and earlier diagnosis of diabetes:
- Organization of 2 World Diabetes Days accompanied by prevention campaigns in the media.
- Establishment of 60 days of screening for diabetes and its risk factors which affected 6,088 people and made it possible to diagnose 488 new people with diabetes.
Strengthening the skills of health professionals
We have set up, with the Ministry of Health, a continuing medical training program in order to strengthen the skills of health professionals in the management of diabetes through two main activities:
- Training of 184 health professionals from hospitals and secondary and community structures on the country's 3 islands.
- Provision of these health structures to strengthen technical platforms (blood glucose meters, Hba1c readers, etc.).
Support to civil society
- Santé Diabète has formed the 3 main associations of the 3 islands: the Comoros Association for the Fight against Diabetes (ACLD), NARIENSHI and the House of Diabetics in Mohéli (MDM).
- Through its interventions, our organization takes care not to replace local actors and seeks capacity building and support for the autonomy of local partners.
Working session with the managers of the central pharmacy for the supply of medicines to Comoros
(Occopharma, september 2018)
Training of Associations of Patients with Diabetes (APAD) organized by Santé Diabète with the support of the NGO Walé in collaboration with the Ministry of Health, Solidarity, Social Protection and Gender Promotion (Moroni, September 2018).
"Thanks to the glycated hemoglobin analysis readers provided by Santé Diabète at Fomboni hospital, I can better treat my diabetes and I no longer have to travel to Mayotte or Tanzania to carry out these analyzes."
Mariatou Assane, a 50-year-old diabetic, previously had to go each year, accompanied by her husband, either to Mayotte or to Dar Es-Salam, to practice this analysis, with very significant financial costs and impacting her whole family.
Dr Aboubacar Said Anli
General Director of Health of Comoros
"Towards a new strengthened South-South collaboration between Mali and the Comoros"
In November 2018, Santé Diabète organized a study visit to Mali so that we can exchange our experiences with their partners in the fight against diabetes. This study visit allowed us to have a very concrete vision of the actions carried out and the way in which the national policy of fight against diabetes is implemented in Mali.
We were first able to talk at length with the Secretary General of the Ministry of Health and the person in charge of NCDs in order to analyze both their strategic positioning, the implementation of their program to fight against NCDs and diabetes as well as the way in which the ministry coordinates this response with all stakeholders (NGOs, patient associations, clinicians, etc.).
We then went to the field to meet the teams and the many actions carried out by Santé Diabète, the Ministry of Health and patient associations. At the end of this very constructive first visit, we will establish, with the support of Santé Diabète, enhanced South-South collaboration between Mali and the Comoros.
Focus: Training of health professionals supported by Reunion University Hospital and Santé Diabète
Santé Diabète continued in 2018, with the Ministry of Health, the training of health professionals working in the hospital structures of the country's 3 islands. In 2017-18, this program touched 153 health professionals from the 3 islands who were trained in the management of diabetes (type 1, type 2, gestational diabetes) and its complications.
The training and teaching contents were produced with the support of the teams of the NGO Santé Diabète as well as with the two heads of endocrinology and diabetology department of the University Hospital Center of Reunion: Dr Nathalie Le Moullec and Dr Xavier Debussche.
The new action program
2017 - 2019
The challenge of this new three-year program is to continue training health professionals in the management of diabetes to install care at the various levels of the health pyramid. This new program will also aim to consolidate the role of patient associations in prevention and therapeutic education actions, but also to develop with the Ministry of Health a national strategy for the prevention and management of diabetes.
Achieving these objectives will involve:
- the organization of 45 days of free screening for diabetes and its risk factors
- awareness :
- 1,000 primary and secondary school students through a prevention cycle on good health behavior
- The training of:
- 45 healthcare professionals managing diabetes, in third reference structures
- 30 health professionals to strengthen their skills in the screening and management of uncomplicated diabetes and in the management of comorbidities in secondary structures
- 48 primary health professionals trained to manage diabetes
- Improving the availability and price of essential drugs in the fight against diabetes
- The definition of a national policy for the fight against Noncommunicable Diseases and a national strategy for the fight against diabetes
- Consolidation of the role and actions of diabetic patient associations
This new triennial program 2017 - 2019 is composed of 2 projects which are consolidated in a program allowing the Comoros to build an ambitious national policy of fight against diabetes.
This program is supported by two historic partners: the French Development Agency (AFD) and the World Diabetes Foundation (WDF).
Donwload the presentation sheet for more information on this program.