Public Health in Practice (Jun 2024)

Implementing HbA1c monitoring in sub-Saharan Africa: Lessons learnt from a pilot project in Mozambique

  • Fausto Ciccacci,
  • Flavio Ismael,
  • Fernanda Parruque,
  • Dércio Júlio Maquete,
  • Sandra Loureiro,
  • Moises Balamala,
  • Leilo Morviducci,
  • Andrea Manto,
  • Fabiana Lanti,
  • Stefano Orlando,
  • Giovanni Guidotti

Journal volume & issue
Vol. 7
p. 100504

Abstract

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Aims: We aimed to evaluate lesson learnt from a pilot project in Mozambique focused on point-of-care (POC) HbA1c testing for diabetes management in primary health care facilities. Methods: Over a three-year period, several health centers were equipped with POC HbA1c testing machines. The evaluation involved 12 months of data collection, interviews with patients and staff, and regular supervision visits. Results: The project screened over 22,000 individuals and provided HbA1c testing to 2362 diabetes patients. Among the analyzed results, 65.7 % had HbA1c levels below 7 %, 10.9 % between 7 % and 8.5 %, and 23.4 % above 8.5 %. POC testing showed advantages such as reduced costs and improved workload management. Conclusions: Limited access to HbA1c testing remains a challenge in African countries. The pilot project demonstrated the feasibility of POC HbA1c testing and highlighted the need for increased efforts to make it more widely available, leading to improved diabetes management and patient outcomes.