Diabetes and Hypertension

Non-communicable diseases (NCDs) such as diabetes and hypertension present a huge health burden in South Africa and people living in rural areas are equally at risk of NCDs as those in urban areas.

Both these diseases are major targets in the Foundation’s flagship health programme, Health in Every Hut (HiEH).

In developing appropriate health interventions to combat non-communicable disease (NCD) such as diabetes and hypertension, it is important to have an accurate profile of the prevalence of NCDs. The DWF is helping to do this with its HiEH programme, in which every household is screened, mapped and those at risk referred for treatment and then followed up.

Health in Every Hut

According to the International Diabetes Federation (Africa), there were 2.28 million cases of diabetes in South Africa in 2015. The prevalence of hypertension and its resultant diseases of cardiovascular disease (CVD) and stroke are equally burdensome. It is well known that CVD is the second leading cause of death in South Africa and it affects all South Africans, across racial and socio-economic barriers.

Since June 2013, HiEH has extended primary health services into the deeply rural Mbashe district of the Eastern Cape in conjunction with the Department of Health (DoH).  We do this by training and utilising community health outreach workers (CHOWs) who go out daily to each and every homestead in a designated area, where they screen residents for the abovementioned NCDs among others. All health indicators/data (including GIS location) is captured on a computer and those at risk are referred to local clinics. Importantly, referred cases are then followed up by teams the Foundation calls embedded CHOWs, all of whom live in the community they serve.

The programme’s framework has been developed to cover four components

IMG_4564CHOWs map and screen rural households to identify primary healthcare needs such as hypertension, diabetes, HIV, TB, maternal and child health issues, dementia, orphans & vulnerable children and social issues. Those found at risk are referred to clinics as explained above.

DWF-381-XLThe Foundation supports DoH clinics through mentoring nurses and assisting improvements in clinic service delivery systems, data capturing and client health education.

DWF-2013-TEAMS-AT-WORK_-48DWF CHOWs living in the community follow up referred patients and support their treatment progress.


DWF runs regular, targeted health awareness and education programmes in schools and the wider community in its area of operation.

Some highlights of the programme for the period June 2013 to Dec 2015 are as follows


More than 9068 households have been visited by Health in Every Hut (HiEH) programme since June 2013 in the Mbashe area


50,000 people have been screened for hypertension, diabetes, HIV, TB, dementia, maternal and child health, orphans and vulnerable children


Initial referrals


Follow-up visits conducted (since June 2014)

HiEH now covers seven areas across the Mbashe district – Hobeni, Bomvana, Madwaleni, Nkanya, Soga, Melitafa, Xhora – encompassing approximately 45,000 people. Additional areas coming on board in 2016 are Mqhele and Mkatazo.

 About the Lilly NCD Partnership

By investing USD 30 million over five years, the Lilly NCD Partnership researches new and comprehensive approaches to fighting NCDs, reports on what works and what doesn’t, and advocates for the best solutions. Lilly works with global and national health organisations in Brazil, India, Mexico and South Africa to identify needs and develop effective programmes that can make sustainable improvements in health outcomes. The Donald Woods Foundation is one of the partners in South Africa.

NCDs account for two-thirds of all deaths around the world. While NCDs affect people in nearly all countries, the burden of these diseases is rising disproportionately in low- and middle-income countries such as South Africa.