Promoting Diabetes Self Management Education [DSME] through Community Based Care in Nigeria

Nigeria has the largest number of people living with diabetes mellitus in Africa and through a period of ten years, there was an over 50% increase in morbidity rates. There is also a twin burden of communicable and non-communicable diseases in Nigeria which influences the poor life expectancy rate of 54 years. Diabetes mellitus is a chronic disease and with the help of the chronic care model, functional and clinical outcomes are highly dependent on an informed, activated patient. In Nigeria, the organization of health care for diabetes has improved to the state of having country specific clinical management guidelines but our outcomes are still far below standards. At present, the care arrangement that is operational is the traditional hospital-based management as well as alternative/unorthodox health care practices. Self-management among people living with diabetes is still very poor and non-adherence to clinical regimen is rampant and greatly influenced by cultural beliefs. The chronic care model is fully functional in developed countries and underway in developing ones. However, there is a dearth of research into effective forms of care outside the clinical settings in Nigeria. In fact, diabetes self-management and education [DSME] in Nigeria, revolves around the secondary care level with few referrals in some states back to the primary health care level. Community based care for diabetes mellitus remains an untapped resource which can go a long way in promoting self-care behaviours especially when it is culturally sensitive and supportive. This review paper aims at exploring barriers and facilitators of community based care for DSME in Nigeria with the goal of producing informed, activated patients who can serves as peer models and can promote disease prevention habits among members of families and communities.