AMPATH Diabetes Programs Expand with Youth Peer-Led Group
The AMPATH Diabetes program recently initiated a peer-led group for young people from rural western Kenya living with type diabetes (T1DM). The group aims to improve the quality of care through improved self-management behaviors and social and emotional support.
The peer-led group supplements existing access to evidence-based services such as tailored insulin therapy, dietary counseling and routine outpatient clinic follow-up at Moi Teaching and Referral Hospital (MTRH) for youth living with T1DM. The clinic is supported by AMPATH partners who provide comprehensive diabetes care through the chronic disease management program.
“Youth with type 1 diabetes from low socioeconomic backgrounds in rural western Kenya experience poorer glycemic control, frequent hospitalizations, and higher mortality rates compared to those with higher socioeconomic status,” said Rachel Ogumbo, AMPATH’s in-country pharmacy lead. “The impact of peer-support and education groups that address social, cultural, and emotional needs involving self-management is yet to be evaluated in this population.”
“As healthcare providers, we try our best to give the best care possible to our patients,” added Dr. Charity Wambui of AMPATH’s Chronic Disease Management program. “We understand the science of the disease, what we don't know is how to live with the disease. Our patients are the experts here! They teach us. more than we teach them.”
LEARN MORE ABOUT AMPATH’S DIABETES PROGRAM
Members of the group include 20 youth (ages 17–25), 4 clinicians (2 clinical officers, 1 nurse and 1 pharmacist), 3 peer supporters, a diabetes educator and a clinic administrator. The group met in March and April to discuss self-management challenges, the proposed group purpose, member aspirations, peer roles, session structure, and strategies to address identified challenges. These challenges include stigma, financial hardship, limited support and healthcare access.
Based on the initial discussions, the group plans to meet in-person for six months for peer-led diabetes self-management education program covering key topics such as nutrition and physical activity, insulin adherence, stigma, myths, mental health challenges (depression and burnout), academic stress, foot care, and the role of technology in effective diabetes management. Each 5-hour session fosters both learning and connection by integrating diabetes education, peer-led discussions on real-life scenarios and social interaction.
Topic experts will be invited to give talks and provide physical examinations such as foot exams and fundoscopies (eye exams) during these sessions. Peers are also given dedicated time to collaborate on potential solutions to identified challenges such as limited community awareness and financial barriers. Additionally, peer group members pair up, conduct bi-weekly phone check-ins and communicate via a WhatsApp group for accountability.
“During the bi-weekly peer-to-peer check-in, we hold each other accountable for the diabetes self-management topic highlighted that month,” explained Darius Maswai, one of the peers in the program. “For instance, if nutrition was the topic of the month, then we will talk about how we have made healthy nutrition choices and what challenges we have been facing.”
“What better way to deal with life as a type one diabetes patient than to talk to other persons living with it daily?” said Dr. Wambui. “That's how we endorsed and fully support the peer support group. From this one initiative we have seen our patients improve their adherence, their glycemic control and they have become more social. We are grateful to have such an initiative and we hope they can inspire even the older patients to come together and support each other.”
Each peer participates voluntarily and made a commitment to work on reducing their glucose level by the 6-month mark. At the first meeting a questionnaire for depression, anxiety, diabetes distress and quality of life is shared with the peers to track psychosocial outcomes of the groups as well.
The members of the group aspire for increased empowerment, better health, economic stability and life skills. They are also looking for a sponsor to partner with them to raise awareness during World Diabetes Day by funding t-shirts printed with key messages about diabetes.