Other Titles
Creating a Model for Leadership in the Multidisciplinary Prevention and Management of Diabetic Foot Complications in Uganda [Title Slide]
Abstract
Background: Diabetes is a global health care problem, with Type 2 Diabetes Mellitus (T2DM) in Sub-Saharan Africa (SSA) projected to increase by 2045 (WHO, 2023). Diabetes health related complications such as foot ulcers (DFU) constitute the largest proportion of admissions, amputations, and mortality and have significant impact on healthcare resources, patients and communities in low to middle income countries (Rigato et al., 2018). Using Burdett Trust for Nursing funding the research team (two nurse researchers, a social scientist, and a biomechanic scientist) wanted to address this issue by introducing 'nurse-led frugal innovations' to demonstrably improve morbidity, reduce mortality, in-patient stays and associated health systems costs.
Aim: The aim of this project was to evaluate the development, delivery and impact of a nurse led diabetes self-management educational (DSME) programme and multidisciplinary diabetic foot clinic on patients and health care staff in Uganda.
Methods: Using a complex interventions approach (Skivington et al., 2021), a mixed method evaluation ran alongside the DSME programme. Patient data included pre and post HbA1c, foot screening, physical activity, medications, weight, BMI, waist circumference, BP, and knowledge, skills and attitudes to diabetes self-management. Focus groups were conducted to examine patients and staff experiences of involvement in the new service model. Quantitative data was analysed using SPSS and qualitative data analysed using thematic analysis (Braun & Clarke, 2021).
Results: A nurse led DSME programme was coproduced by 12 staff and 5 service users utilising findings from a scoping review (Sajiith et al., 2024) and delivered over 3 cohorts between January and June 2024. 34 adults completed the DSME and attended the DFU prevention clinic. Findings show statistically and clinically significant improvements in HbA1c. Participants showed an increase in self-management activities, became advocates and champions of a healthy lifestyle to family, friends and work colleagues. Previously held view of diabetes being a death sentence were lifted.
Conclusion: This feasibility study reports on the mixed methods findings of a nurse led culturally congruent, frugal, co-produced DSME programme in Uganda and the implications for future policy, practice and sustainability.
Notes
References:
Braun, V., & Clarke, V. (2021). Thematic analysis: A practical guide. Sage: London.
Rigato, M., Pizzol, D., Tiago, A., Putoto, G., Avogaro,. A, & Fadini, G.P. (2018) Characteristics, prevalence, and outcomes of diabetic foot ulcers in Africa. A systemic review and meta-analysis. Diabetes Research and Clinical Practice. 142:63–73. doi: 10.1016/j.diabres.2018.05.016, PMID.
Sajith, R., Ackers, L., Ackers-Johnson, S., Parker, D., & Stephens, M. (2024). The practice, nature and impact of nurse-led type 2 diabetic foot prevention services and educational programmes in Sub-Saharan Africa: a scoping review Authors. Frontiers in Public Health, 12, p.1465750.
Skivington, K., Matthews, L., Simpson, S.A., Craig, P., Baird, J., Blazeby, J.M. et al. (2021). A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance BMJ. 374 :n2061 doi:10.1136/bmj.n2061
World Health Organisation (2023) Non-Communicable Diseases. Accessed 11 November 2025 from https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
Sigma Membership
Phi Mu
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Mixed/Multi Method Research
Keywords:
Health Equity or Social Determinants of Health, Public and Community Health, Sustainable Development Goals, Diabetes Mellitus Type 2, Self-Management, Patient Education, Nursing Interventions, Uganda
Recommended Citation
Stephens, Melanie; Ackers, Louise; Sajiith, Rincy; Parker, Daniel; and Namirro, Rachel, "Evaluating an Innovative Frugal Nurse-Led Diabetes Self-Management Educational Programme in Uganda" (2026). International Nursing Research Congress (INRC). 90.
https://www.sigmarepository.org/inrc/2026/presentations_2026/90
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-29
Evaluating an Innovative Frugal Nurse-Led Diabetes Self-Management Educational Programme in Uganda
Toronto, Ontario, Canada
Background: Diabetes is a global health care problem, with Type 2 Diabetes Mellitus (T2DM) in Sub-Saharan Africa (SSA) projected to increase by 2045 (WHO, 2023). Diabetes health related complications such as foot ulcers (DFU) constitute the largest proportion of admissions, amputations, and mortality and have significant impact on healthcare resources, patients and communities in low to middle income countries (Rigato et al., 2018). Using Burdett Trust for Nursing funding the research team (two nurse researchers, a social scientist, and a biomechanic scientist) wanted to address this issue by introducing 'nurse-led frugal innovations' to demonstrably improve morbidity, reduce mortality, in-patient stays and associated health systems costs.
Aim: The aim of this project was to evaluate the development, delivery and impact of a nurse led diabetes self-management educational (DSME) programme and multidisciplinary diabetic foot clinic on patients and health care staff in Uganda.
Methods: Using a complex interventions approach (Skivington et al., 2021), a mixed method evaluation ran alongside the DSME programme. Patient data included pre and post HbA1c, foot screening, physical activity, medications, weight, BMI, waist circumference, BP, and knowledge, skills and attitudes to diabetes self-management. Focus groups were conducted to examine patients and staff experiences of involvement in the new service model. Quantitative data was analysed using SPSS and qualitative data analysed using thematic analysis (Braun & Clarke, 2021).
Results: A nurse led DSME programme was coproduced by 12 staff and 5 service users utilising findings from a scoping review (Sajiith et al., 2024) and delivered over 3 cohorts between January and June 2024. 34 adults completed the DSME and attended the DFU prevention clinic. Findings show statistically and clinically significant improvements in HbA1c. Participants showed an increase in self-management activities, became advocates and champions of a healthy lifestyle to family, friends and work colleagues. Previously held view of diabetes being a death sentence were lifted.
Conclusion: This feasibility study reports on the mixed methods findings of a nurse led culturally congruent, frugal, co-produced DSME programme in Uganda and the implications for future policy, practice and sustainability.
Description
Diabetes is a global health care problem significantly impacting healthcare resources, patients and communities in low to middle income countries. Frugal nurse led innovations are needed to address this issue to improve population health. Using a complex interventions approach the researchers evaluated the development, delivery and impact of a co-produced diabetes self-management educational (DSME) programme and multidisciplinary diabetic foot clinic on patients and health care staff in Uganda.