Worldwide, non-communicable diseases (NCD) currently represent 43% of the burden of diseases and are expected to be responsible for 60% of the disease burden and 73% of all deaths by 2020. About 346 million people have diabetes and more than 80% of diabetes deaths occur in low- and middle-income countries. Diabetes deaths will double between 2005 and 2030. In Morocco, non-communicable diseases are responsible for 55.8% of the overall burden of diseases and diabetes prevalence has been estimated at around 7% of the population The response to non-communicable disease like diabetes is complex and health systems are not prepared to tackle diseases that do not heal and need to be treated and managed continuously as part of the daily life of patients and their families. In response to this challenge, the World Health Organization has developed the Innovative Care for Chronic Conditions Framework. This framework is centered on a triad of partnerships between the patient, the health care team and the community. Even if community action has been recognized by the Ottawa charter as a pillar of health promotion, the debate over the real capacity of community action to empower people and improve health is still relevant given that patients’ empowerment is a major issue to control NCD. In the Moroccan context, we are experiencing a proliferation of civil society organizations that support diabetes patients, but this phenomenon has not been investigated although these organizations are increasingly recognized as an important actor widely represented in the different regions of Morocco. Our research question regards the role of diabetic associations on the empowerment of diabetic patients. This research question could be divided into two research sub-questions: • To what extent do diabetic associations contribute to diabetic patients’ empowerment? and what characteristics of associations make them more empowering than others ? • To what extent (under which conditions) does patient’s empowerment lead to improving clinical and quality of life outcomes? We will try in this protocol to answer to the first research sub-question. Our objectives are to describe the characteristics (including activities) of the diabetic associations and analyze the different factors that determine their capacity to be empowered. We will conduct a qualitative study with a descriptive and interpretative perspective, in the prefecture of Marrakesh and the province of Al Haouz. Our study population will consist of the leaders and the members of diabetics associations, health professionals dealing with diabetics associations from the private and public sectors and the other partners working with diabetic associations (Politicians, territorial administration, and Pharmaceutical industry, Regional department of health, Diabetes prevention and control program managers). We will explore the following dimensions: The determinants of the creation of the association, the evolution of the association over time, the reasons of becoming a member of such diabetes associations, the mission and goals of diabetics associations, the organizational characteristics of associations (participation and leadership, resource mobilization, role of external agents not directly related to diabetes in association, activities and accomplishments of associations, collaboration of the association with health services and with other partners such as associations, local authorities, elected representatives, pharmaceutical industry). We will also investigate through a self-assessment of the association leaders the association’s realizations and the perception of diabetic patients about the association. Our work will help enabling health system to be more proactive in working with community actors acting in the field of diabetes by clarifying their roles and integrating them in the management of diabetes and the others non communicable diseases.
|Effective start/end date||1/03/11 → 7/10/16|
IWETO expertise domain