ArticleSouth African family practice : official journal of the South African Academy of Family Practice/Primary Care2024
The sustainability of group empowerment and training for people with diabetes in South Africa.
Article in South African family practice : official journal of the South African Academy of Family Practice/Primary Care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Implementation strategies for evidence-based management of type 2 diabetes at primary healthcare facilities in low- and middle-income countries and related barriers and facilitators: a scoping review.Implementation science communications · 2026Pooled it
- Evaluating the implementation of group empowerment for people with type 2 diabetes at Grassy Park Community Day Centre, Cape Town: A convergent mixed-methods study.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2025Article
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Authors and funding
2 authors.
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Abstract
backgroundGroup empowerment and training (GREAT) for people with type 2 diabetes enables self-management and lifestyle modification. GREAT for diabetes was implemented in primary care facilities in five South African provinces in the beginning of 2022. The aim was to evaluate implementation and to particularly explore factors that influenced the sustainability of implementation.
methodsAn exploratory, descriptive qualitative study conducted semi-structured individual interviews with 17 key stakeholders at the end of 2023. Interviews explored factors within a theory of change framework derived from an initial evaluation in 2022. Data were analysed using the framework method and ATLAS.ti.
resultsImplementation and scale-up was sustained in the Western Cape. Governance and financing at a provincial and district level were key to health system structures. Space, staffing, resource materials and monitoring of implementation were key to the inputs. Facility managers, training and performance of facilitators, including the whole team, selecting patients, patient flow and appointments, stakeholder support and clinical governance were key to service delivery. Facilities that had implemented, reported reaching 300 patients per year. A range of motivational, behavioural and clinical outcomes were reported. Future implementation could include community health workers and group empowerment for insulin initiation.
conclusionImplementation and scale-up was only sustained in one province and a range of factors related to sustained implementation were identified.Contribution: The factors identified can guide the successful implementation and scale-up of GREAT for diabetes in South Africa.
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