Current policies and practices for the provision of diabetes care and self-management support programmes for older South Africans

Afr J Prim Health Care Fam Med. 2019 Aug 29;11(1):e1-e12. doi: 10.4102/phcfm.v11i1.2053.

Abstract

Background: One of the most important primary health challenges currently affecting older people in South Africa (SA) is the increasing prevalence of non-communicable disease (NCD). Research is needed to investigate the current state of care and self-management support available to older diabetic patients in SA and the potential for interventions promoting self-management and community involvement.

Aim: This study aimed to review current policies, programmes and any other interventions as they relate to older people with diabetes with a view to assess the potential for the development of a self-management programme for older persons attending public sector primary health care services in Cape Town, South Africa.

Setting: Eighteen community health centres (CHCs) formed the sampling frame for the study.

Methods: This study aimed to review current policies and programmes as they relate to older people with diabetes. It involved a documentary review and qualitative individual interviews with key informants in the health services and Department of Health.

Results: Several national initiatives have sought to advance the health of older people, but they have only been partially successful. There are however multiple efforts to re-orientate the health-care system to focus more effectively on NCDs, which benefit older patients with diabetes. The establishment of community-based services to provide self-management support, promote health and ease access to medicine helps overcome many of the commonly cited barriers to care experienced by older patients. What may be equally important is that practitioners gain the communication skills and educational resources to effectively educate and counsel patients on lifestyle behaviour change and self-care management.

Conclusion: This article alerts policy-makers and clinicians to some of the specific issues considered to be pertinent and important in the care and management of older diabetic patients. Many of these would also be applicable to older patients with other chronic conditions.

Keywords: South Africa; diabetes care; diabetes self-management programmes; older patients with diabetes; primary health care.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Community Health Services / legislation & jurisprudence*
  • Community Health Services / organization & administration
  • Diabetes Mellitus*
  • Female
  • Health Policy*
  • Health Services for the Aged / legislation & jurisprudence*
  • Health Services for the Aged / organization & administration
  • Humans
  • Male
  • Middle Aged
  • Primary Health Care / legislation & jurisprudence*
  • Primary Health Care / organization & administration
  • Program Evaluation
  • Psychosocial Support Systems
  • Qualitative Research
  • Self-Management
  • South Africa