**6. Principles of family-centred care**

The FCC principles are frequently aligned with a vision of effective health care delivery as described by Johnson and Abraham [17], and are as follows:


*Lifestyle and Epidemiology - The Double Burden of Poverty and Cardiovascular Diseases...*

among older outpatients at rural areas.

**2. Diabetes burden**

So far, family-centered diabetes care has been successful and produced better diabetes outcomes in children, who are helped by family members to carry certain relevant tasks related to self-care practices [7]. Less focus has been given to older people who are mostly affected by diabetes [3]. Therefore, this book chapter is intended on closing the gap by advocating for the family-centered diabetes care

Approximately 9% of people worldwide have diabetes and that 90% of the diabetic cases are Type 2 Diabetes Mellitus (T2DM) cases [8]. Over 80% of diabetes cases are those living in developing countries [9]. Type-2 diabetes is rising in Africa and threatening public health sector particularly because it is predisposing factor to various NCDs including diabetes, and its prevalence is anticipated to increase by 110% over the next two decades, from 19.8 million individuals in 2013 to 41.5 million by 2035 [1]. Inactive lifestyle characterized by lack of exercise and poor eating habits are a problem in South Africa leading obesity and subsequently increased diabetes prevalence and complications. Around 7% of South Africans aged 21 to 79 years have diabetes mellitus [1]. The prevalence of DM among South Africans aged 30 years or more has expanded since 2009, and 11 million increase are anticipated in the year 2020 [10]. Statistics SA [2] further points out that diabetes mellitus and different types of heart diseases are part of the ten leading causes of death in all parts of SA. The StatsSA [2], reported that Limpopo Province has DM prevalence rate of 5.2% and is the fourth province with highest DM

prevalence, while Western Cape Province leads with of 6.9% DM prevalence.

Diabetes outpatients receive treatment at Primary Health Care (PHC) facilities,

which is nurse driven. The South African Department of Health, in an attempt to manage chronic diseases including DM introduced Chronic Disease Outreach Program (CDOP) to follow-up on patients, particularly those with NCDs [11]. In line with CDOP, health professionals such as general practitioners, dietitians, physiotherapists and psychologists regularly visit PHC facilities to see patients requiring their services. Diabetes patients are required to consult these healthcare professionals 2–3 a years. The introduction of the outpatient's services in SA helped in reducing management costs which are imposed by mere presence of diabetes, and more costly in the presence of complications. The outpatient services also helped in

The diabetes team for the treatment and care of outpatients at PHC facilities with recognition of the outreach programs by other healthcare professionals who

The FCC is defined as "provision of healthcare in partnership or in recognition that the family has a role to play in the treatment of persons living with chronic

**3. Provision of diabetes healthcare services to outpatients**

improving family involvement in the care of loved ones.

**4. Assembling diabetes team for the care of outpatients**

may not be full time at the PHC facilities, and are as follows:

**5. Family-centered diabetes care**

**260**


#### **Table 1.**

*Diabetes team and their responsibilities.*
