Project Overview

The Tshwane Insulin Project (TIP) is an innovative 5-year translational research programme designed to address the hurdles to insulin use in primary healthcare in South Africa. The aim of the project is to design, implement and evaluate a nurse-led, community worker-assisted and patient-centred innovative model of care that will facilitate insulin use for people with Type 2 diabetes in primary care in the City of Tshwane Metropolitan Municipality.

Project objectives

The programme is a multiphase intervention which design is based on the Normalisation Process Theory (NPT).

Phase 1: Identification of challenges and opportunities for insulin therapy

• Objective 1: To identify the barriers and opportunities for insulin initiation and titration at primary care level in the Tshwane District from both patients and healthcare providers’ perspective.
• Objective 2: To identify the gaps in diabetes care as well as missed opportunities for intensification of therapy including insulin therapy through a review of medical records.

Phase 2: Review of the legal and policy framework

• Objective 3: To conduct a document review and analysis of the current guidelines and policies for diabetes care as well as relevant legislation in order to improve insulin initiation at primary care level.

Phase 3 and 4: Evaluation of the proposed model of care

• Objective 4: To evaluate the safety and feasibility, then the effectiveness of the model of care that will facilitate insulin initiation and titration in primary care facilities in the Tshwane District.

Phase 5: Implementation into routine care

• Objective 5: To ensure the translation of research findings into practice by providing technical assistance to health departments and relevant stakeholders.

Approvals have been obtained from the University of Pretoria’s Faculty of Health Sciences Research Ethics Committee (No.: 496/2018) and the Tshwane Research Committee (NHRD GP_201810_049).

Funding

The programme is sponsored by the Lilly Global Health Partnership