Evaluation of diabetic peer support in Malawi

Area of Science:

• Endocrinology and Metabolic Diseases
• Public Health and Health Policy
• Behavioral Medicine

Background:

• Type 2 diabetes poses a significant global health challenge, necessitating urgent attention from healthcare providers and policymakers.
• Healthcare worker shortages in low-income countries highlight the need for alternative management strategies, such as peer support programs.
• Peer support programs have demonstrated effectiveness in managing diabetes, particularly in sub-Saharan Africa.

Purpose of the Study:

• To evaluate the impact of the Kamuzu Central Hospital (KCH) diabetic peer support program (DPSP) four years post-establishment.
• To compare the knowledge, self-efficacy, and behaviors of DPSP members with those of non-members.

Main Methods:

• A cross-sectional study was conducted among diabetic patients at KCH between August 12 and September 25, 2018.
• Participants (n=176) were consecutively recruited after providing informed consent.
• Data were collected using self-administered and interviewer-administered questionnaires based on validated instruments.

Main Results:

• DPSP members exhibited greater knowledge regarding the impact of meal skipping and sugary drinks on blood glucose levels and non-diabetic conditions.
• DPSP members reported higher self-efficacy in managing hypoglycemia, communicating concerns to healthcare workers, and performing daily foot examinations compared to non-members.

Conclusions:

• The KCH Diabetes Peer Support Program (DPSP) has positively influenced its members, indicating its value in diabetes care.
• The program's success suggests it should be expanded to include all diabetic patients in Malawi.
• Continuous training for peer supporters is crucial for maintaining program fidelity and enhancing management skills.