Open AccessHealth service delivery for type 1 diabetes during the lockdown in Uganda following the coronavirus disease 2019 pandemic
Author(s) -
Silver Bahendeka,
Thereza Piloya,
Jasper Oo,
Ronald Wesonga,
Gerald Mutungi,
Wenceslaus Sseguya,
Denis Mubangizi
Publication year - 2021
Publication title -
healthcare in low-resource settings
Language(s) - English
Resource type - Journals
ISSN - 2281-7824
DOI - 10.4081/hls.2021.9799
Subject(s) - medicine , pandemic , diabetes mellitus , medical emergency , type 2 diabetes , emergency medicine , covid-19 , disease , disease control , family medicine , infectious disease (medical specialty) , environmental health , endocrinology
Lockdown measures to reduce the spread of coronavirus disease 2019 (COVID-19), may adversely impact on diabetes supplies and metabolic control, especially in type 1 diabetes in low-resource countries. To address this, we conceptualized a service delivery model that incorporated a digitized tool. The digitized tool (UT1D-HIMAS) maintained electronic health records, monitored clinic supplies, patient clinic visits and admissions, and sent automated SMS messages. Delivery of supplies was by motor vehicles, motorcycles, bicycles or patients/caregivers walking to clinics. Metabolic control was assessed by glycated haemoglobin (HbA1c). Monitoring of clinic supplies including emergency restocking, patient clinic visits and admissions, and sending automated SMS by UT1D-HIMAS were successfully achieved. A fall in clinic visits, reaching a nadir (67.9%) in May 2020 was observed. HbA1c (mean ± SD mmol/mol) significantly (p= 0.040) worsened from 79.1 ± 26.8 to 94.9 ± 39.2 and (p=0.002) from 67.1 ± 22.7 to 84.8 ± 39.4 in the rural and urban clinic respectively. The digitized health information system exhibited high practicability in tracking stocks, clinic visits and hospitalisation but failed to improve metabolic control.