At Maziba Health Centre IV in Kabale district, Uganda, patients like Sarah are now receiving integrated screening for hypertension and diabetes, supported by the World Health Organization (WHO) and World Diabetes Foundation (WDF). These services provide patients with clear information about their health status and a management plan, marking a shift towards holistic, patient-centred care.
Uganda is one of only two countries implementing the four-year Diabetes and Cardiovascular Disease (D-CARD) Africa Project, launched in 2024. The initiative integrates non-communicable disease (NCD) screening into existing health services, including HIV, TB, and malnutrition programs. In Uganda, the project operates in Kabale, Koboko, Lira, and Sembabule districts, targeting over 1.1 million people across ten primary healthcare facilities per district, focusing on early detection and management of diabetes and hypertension at the community level.
The project has equipped health facilities with essential medical equipment, including blood pressure monitors, glucometers, ECG machines, and HbA1c analyzers, distributed to 40 primary health centres in the focal districts. Over 625 healthcare providers have been trained through workshops and continuous medical education, emphasizing routine screening for every patient, regardless of presenting complaints. This approach has significantly improved early detection and intervention for diabetes and hypertension.
D-CARD has also fostered patient-led support groups, such as the Maziba Health Centre IV NCD Group, which comprises over 100 members. These groups improve adherence to treatment, facilitate access to medicines during occasional stock-outs, and provide peer support. Members contribute to a communal fund to purchase medications when government supplies are unavailable, reinforcing community-driven solutions.
District leadership has been pivotal in supporting the sustainability of these interventions, promoting integration of patient groups into government programs and local structures. WHO and its partners emphasize that strong district engagement, combined with training and mentorship, is essential for building resilient, community-based health systems.
Diabetes and hypertension remain significant public health challenges in Uganda, with many individuals unaware of their condition, delaying treatment, and increasing the risk of severe complications. The 2023 Uganda STEPS Survey reports that 26.4% of adults have raised blood pressure, yet only 10.4% are aware, and 3.5% have it under control. Diabetes affects 3.3% of adults, with over 59% of those aged 30 and above not receiving treatment.
Through integrated chronic care clinics, the D-CARD project strengthens early diagnosis, routine screening, and management of NCDs while maintaining concurrent HIV, TB, and malnutrition services. WHO continues to support scaling up these services, prioritizing formalized patient support groups, uninterrupted access to essential medicines, health worker training, and evidence-based decision-making. These measures aim to accelerate early detection, holistic management, and long-term sustainability of diabetes and hypertension care, advancing Uganda’s journey toward resilient primary healthcare.
