A Case Study in Harare: Longitudinal Assessment of a Community Health Worker-Led Diabetes Self-Management Education Programme in Mbare and Highfield

Diabetes prevalence is rising in urban Zimbabwe, placing strain on public health services. Community-based strategies are required to support chronic disease management. This case study examines a local initiative in two high-density suburbs of Harare. The study aimed to longitudinally assess the implementation and perceived impact of a community health worker-led diabetes self-management education programme for adults in the suburbs of Mbare and Highfield, Harare. A qualitative, longitudinal case study design was employed. Data were collected through serial focus group discussions with programme participants and in-depth interviews with community health workers and local health centre nurses. Field notes from programme observation sessions were also analysed. The programme demonstrated feasibility and high participant engagement. A key theme was participants’ enhanced sense of agency in managing their diabetes. A notable proportion of interviewed participants reported improved adherence to medication and dietary advice following the education sessions. Challenges included intermittent supply of educational materials and glucometer test strips. The community health worker-led model shows promise as a sustainable adjunct to clinic-based diabetes care in this resource-constrained urban setting, fostering improved self-management behaviours. Integrate the programme more formally into the local primary healthcare structure. Secure consistent supplies for monitoring and education. Explore scaling the model to other suburbs with similar training and supervision frameworks. Diabetes mellitus, self-management, community health workers, case study, Zimbabwe, urban health, health education This case study provides practical insights for policymakers and practitioners on implementing community-based diabetes support in urban African settings, highlighting a viable model for task-sharing.