Towards more effective strategies for management of diabetes in Mauritius

Over the past 2 decades, the prevalence of diabetes in Mauritius has remained one of the highest in the world with no recent significant improvement. Mauritius ranked 2nd in 2002 and 4th in the world in 2009 with nearly one in five of its adult population above the age of 30 years being affected. Nearly half of those affected do not know that they have the disease and this adversely influences quality of life, risks of complications as well as morbidity and mortality. Despite the availability of free health services, over 50% of diabetes patients are poorly controlled and the risk of complications from diabetes such as cardiovascular diseases, renal failure, blindness, peripheral vascular and neurological diseases leading to lower limb amputations, remain very high. Despite continued efforts from the Ministry of Health and Quality of Life (MOH & QOL) to provide easily accessible diabetes care to all patients, the outcome remains poor. Most of the outpatients and primary health care centres are overcrowded and the set-up does not provide optimal care and attention. Diabetes care is very much medical-orientated and the health promotion campaigns have had little impact so far. Prevention and control of diabetes must become a priority. There is an urgent need for enhanced heath promotion and education, as evidence suggests that a change in diet and lifestyle can bring about significant improvement in the incidence and prevalence of diabetes. This paper examines some of the key actions/ proposals with respect to: evaluation of actions taken, health promotion campaigns, attitude and behavioural change, focused leadership and commitment, marketing strategies, effective segmentation and targeting.