P-45: Impact of the changing diabetes in children (CDiC) project on type 1 diabetes care in pastoralist communities: evidence from Isiolo county, Kenya
N AlioAbstract
Introduction
Type 1 diabetes mellitus is a lifelong condition requiring continuous insulin, monitoring, and care. In pastoralist and hard-to-reach settings like Isiolo County, Kenya, management is limited by poor access to commodities, low awareness, and stigma. Children often face delayed diagnosis, poor adherence, and complications due to cultural beliefs, mobility, and weak health systems. The CDiC project at Isiolo County Referral Hospital addresses these gaps through insulin and glucometer provision, healthcare worker training, and community sensitization to improve awareness, reduce stigma, and strengthen health-seeking behavior.
Objectives
To evaluate the role of the CDiC project in improving type 1 diabetes care through enhanced access to insulin and monitoring tools, strengthened healthcare capacity, and community sensitization, and its influence on stigma reduction and health-seeking behavior in Isiolo County.
Methods
A descriptive program evaluation used CDiC routine data at Isiolo County Referral Hospital. Data included patient records, clinic attendance, and reports. Analysis assessed insulin access, training, sensitization, stigma, and retention in care.
Results
A total of 127 children with type 1 diabetes are enrolled in care. Clinic follow-up improved to 87%. Access to insulin and glucometers reached 100%, with >80% adherence. Community sensitization reached 5,000+ households, improving awareness and reducing stigma. Health-seeking behavior improved with earlier diagnosis. Over 70 healthcare workers and CHPs were trained, strengthening service delivery. Overall, the program improved outcomes, retention, and quality of life.
Conclusions
The CDiC project has significantly improved access to care, reduced stigma, and strengthened health-seeking behavior among children with type 1 diabetes in pastoralist communities. It demonstrates that integrated, community-centered approaches can improve chronic disease outcomes in resource-limited settings and offers a scalable model for similar contexts.