Abstract
Introduction. The prevalence of diabetes mellitus is rapidly rising in SSA. Interventions are needed to support the decentralization of services to improve and expand access to care. We describe a clinical mentorship and quality improvement program that connected nurse mentors with nurse mentees to support the decentralization of type 2 diabetes care in rural Rwanda. Methods. This is a descriptive study. Routinely collected data from patients with type 2 diabetes cared for at rural health center NCD clinics between January 1, 2013 and December 31, 2015, were extracted from EMR system. Data collected as part of the clinical mentorship program were extracted from an electronic database. Summary statistics are reported. Results. The patient population reflects the rural settings, with low rates of traditional NCD risk factors: 5.6% of patients were current smokers, 11.0% were current consumers of alcohol, and 11.9% were obese. Of 263 observed nurse mentee-patient encounters, mentor and mentee agreed on diagnosis 94.4% of the time. Similarly, agreement levels were high for medication, laboratory exam, and follow-up plans, at 86.3%, 87.1%, and 92.4%, respectively. Conclusion. Nurses that receive mentorship can adhere to a type 2 diabetes treatment protocol in rural Rwanda primary health care settings.
| Original language | English (US) |
|---|---|
| Article number | 2657820 |
| Journal | Journal of Diabetes Research |
| Volume | 2017 |
| DOIs | |
| State | Published - 2017 |
Funding
The authors acknowledge Partners In Health/Inshuti Mu Buzima for the support of this work. This study was developed under the Partners In Health/Inshuti Mu Buzima Intermediate Operational Research Training Program, developed and facilitated by Bethany Hedt-Gauthier and Jackline Odhiambo. The authors acknowledge the contributions of NCD nurse mentors and mentees to the NCD MESH-QI program and patient care. The authors’ acknowledgement further goes to the Monitoring and Evaluation Department and the Health Management Information System teams at Partners In Health/Inshuti Mu Buzima for the data entry and data quality checking. The authors also acknowledge the initial and ongoing implementation efforts of the integrated NCD clinic model from our Rwandan and US colleagues at the Rwandan Ministry of Health and Partners In Health. The authors gratefully acknowledge the financial support from the Doris Duke Charitable Foundation, through PHIT Partnership funding for the implementation of this study. The authors also acknowledge the Helmsley Charitable Trust for their support in the implementation of the decentralized NCD program. Training costs were covered by the Harvard Global Health Initiative Burke Global Health Fellowship grant and by Partners In Health/Inshuti Mu Buzima. Some training facilitators and mentors are from Rwanda Human Resources for Health faculty funded by the Global Fund to fight AIDS, Tuberculosis and Malaria and Centers for Disease Control and Prevention. Funding was also provided for some mentors by the Global Health Research Core, Harvard Medical School.
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
- Endocrinology
