29 November, Mbabane: The Government of the Kingdom of Swaziland dedicated the whole month of November to Diabetes awareness, with a special focus on women in line with the World Diabetes Day 2017 theme: “Women and diabetes - our right to a healthy future”.

The awareness campaign was launched on the 1st of November through a breakfast meeting held at Mountain Inn Hotel in Mbabane and attended by different stakeholders including individuals living with diabetes. This was followed by a number of events held in different parts of the country; all aimed at creating awareness about diabetes and ensuring access to services to all. The major highlight of the month was the community event held on the 16th of November at Mafutseni Inkhundla in the Manzini region.

The events were supported by the Ministry of Health, through the Non Communicable Disease Prevention and Control Programme, the World Health Organization (WHO), Swaziland Diabetes Association, the Swaziland Breast and Cervical Cancer Network (SBCCN) and other community based organisations. Information on the prevention and control of diabetes was disseminated to different target audiences through different channels. Members of the public had an opportunity to check their blood sugar, blood pressure, body mass index, receive advice on healthy lifestyle as well as access cervical and breast cancer screening services. This was really appreciated by community members.

As the focus was on women, the three key messages were, firstly that all women with diabetes require affordable and equitable access to care and education to better manage their diabetes and improve their health outcomes. The second message was that pregnant women require improved access to screening, care and education to achieve positive health outcomes for mother and child. Lastly that women and girls are key agents in the adoption of healthy lifestyles to improve the health and well-being of future generations. Everyone was encouraged to “act today to change tomorrow”. Diabetes and its complications can be significantly reduced by maintaining a healthy body weight, engaging in sufficient amounts of physical activity, eating a well-balanced diet, and avoiding tobacco and harmful use of alcohol throughout the life course.

These messages were echoed by different speakers during the different events. One of the speakers who is a champion for diabetes inspired a lot of people through her testimony. She is a young lady living with Human Immunodeficiency Virus (HIV) infection, diabetes and at one point suffered from Tuberculosis. At that point she had to overcome the challenges of taking medication for and meeting the dietary requirements of all three conditions. Management of these conditions was not integrated so she had to honour different review appointments for all the conditions. She confessed that life was not easy but with support from health workers, Swaziland Diabetes Association, community and family members she is alive to tell the story. Another champion also narrated that she was forced to retire on medical grounds from her teaching profession after undergoing amputation of her right leg due to diabetes. However with support from her children she overcame moments of depression and despair.

The Honourable Minister of Health Senator Sibongile Ndlela-Simelane emphasised that early detection and effective management of diabetes among women is crucial. Swaziland is facing an increasing burden of diabetes and other non-communicable diseases hence the Minister reiterated that the Government of the Kingdom of Swaziland is working towards strengthening the response to non-communicable diseases in line with the 2011 Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases.  She stated that efforts are being made to decentralise services for the prevention and control of diabetes and other NCDs in line with the WHO Package of Essential Non Communicable Diseases at Primary Care Level (WHO-PEN). She added that the country is well placed to learn from the successes of the decentralisation of HIV treatment services that took place over the past 15 years with major successes.  

The WHO Country Representative, Dr Tigest Ketsela Mengestu emphasised that Swaziland needs robust diabetes prevention and control policies to promote healthy diets and physical activity at home, schools, workplaces and other settings. She also noted that as the focus this year is on women, diabetes prevention strategies need to focus on maternal health and nutrition and other health behaviours before and during pregnancy, as well as infant and early childhood nutrition. She said antenatal care visits during pregnancy must be optimised for health promotion in young women and early detection of diabetes. “Screening for diabetes should be integrated into other maternal health interventions and services at primary healthcare level to ensure early detection, better care for women and reduced maternal deaths. Healthcare workers should be trained in the identification, treatment, management and follow up of diabetes during pregnancy,” she said.

Diabetes in the African region including Swaziland is a serious, chronic and costly disease that affects both males and females and is estimated to rise to 23.9 million cases by 2030. Globally 1 in 10 women are living with diabetes and 2 out of every 5 of these women are of reproductive age. Of note is the fact that 1 in 7 births are affected by pregnancy induced diabetes and women with type 1 diabetes have an increased risk of early miscarriage or having a baby with malformations. 

Let us therefore focus on “Women and diabetes - our right to a healthy future”.