Collaboration among the Traditional and Biomedical Health Care sector in the Management of Diabetes and Hypertension in line with health care system in Zanzibar

The project has been initiated and funded by World Doctors (Senior Project Manager Dr. Tanja Nienstedt) and is being implemented in partnership with the local NGO JUWAZA (Zanzibar Association of Retirees and Elders), with the aim of utilizing resources of a culturally rooted healthcare system, reaching out to as many patients as possible.

Introduction and background:

IDF (International Diabetes Foundation) 2021: 537 million adults (20-79 years) are living with diabetes - 1 in 10. This number is predicted to rise to 643 million by 2030 and 783 million by 2045.

Over 3 in 4 adults with diabetes live in low- and middle-income countries.

Diabetes is responsible for 6.7 million deaths in 2021 - 1 every 5 second.

  • People living with Diabetes are up to three times more likely to develop cardiovascular diseas
  • 1 in 3 people with Diabetes will develop some form of vision loss during their lifetime.
  • Kidney failure is 10 times more common in people with diabetes.
  • A lower limb is lost to Diabetes every 30 seconds worldwide. Loss of a limb is serious in any setting, but potentially catastrophic in a society with limited social security structures.

The total number of people with Diabetes in Africa is predicted to increase by 129% to 55 million by 2045.

Tanzania / Zanzibar

Tanzania/Zanzibar is among the top five countries in Sub-Saharan Africa (including South Africa, Nigeria, Ethiopia, Democratic Republic of Congo) in terms of number of people with Diabetes and related complications mentioned above.

Therefore, it is of utmost importance to develop new prevention and screening methods.

According to WHO data, 80% of the Sub-Saharan population primarily trusts traditional medicine and its practitioners due to its cultural acceptance, affordability, as well as easy accessibility as a healthcare service. The World Health Organisation (WHO) recognises the crucial role of traditional healers in disease prevention, including safe motherhood. In addition, preserving natural resources, including traditional medicine, has been designated as a Millennium Development Goal (Goal 7).

In the light of the above and as a starting point for a pilot project in Zanzibar, a baseline research study was conducted with the University of Berlin on the topic of 'Bridging Gaps in Health Care and Healing: Traditional Medicine and the Biomedical Health Sector'. The study involved anthropologists, representatives of the traditional healer community, the Ministry of Health, and medical personnel to determine the acceptance and health policy potential of the project. 

Project area: Urban West, Zanzibar Population 893.169

Project duration: Indicative term of 3 years.

Overall objective:

To improve diabetes/hypertension management in line with the Zanzibar health system.

Specific objectives:

  • To increase collaboration between traditional healers and doctors in the field of hypertension and diabetes.
  • Increased awareness and behavior change of traditional healers in the management of diabetic and hypertensive patients and their referral to primary health care and hospitals.
  • Increased awareness of hypertension and diabetes among influential leaders and communities
  • Proper preparation of traditional medicines according to Moh criteria and registration of these products with the Zanzibar Food and Drugs Authority (ZFDA).
  • Strengthen home care by traditional healers for patients with non-communicable diseases.

Intermediate outcome:

Meanwhile, 50 traditional healers who have been selected and officially registered have received training in basic knowledge of Diabetes, Hypertension, and general complications, including those during pregnancy. They have also been trained in the use of diagnostic tools such as blood pressure and blood glucose meters, as well as in completing medical records, reference forms, and monthly patient summaries. They have been provided with the necessary materials and issued a training certificate.

Meetings have taken place between the Ministry of Health leadership and doctors from district hospitals and clinics to establish the specifics of working with certified healers. 

Monthly visits will be made to assess their performance and address any management issues. Additionally, evaluations are scheduled to take place every six months and annually, in compliance with international standards. It is intended that these evaluations will be shared with the Ministry of Health.

Safe Motherhood

The construction of 4 maternity wards in Tanzania were the first projects of our association. In cooperation with the association CUAMM Medici con l'Africa, which has implemented and manages the projects in Africa, the Autonomous Province of Bolzano and the Diocese of Dar Es Salaam, we were able to finance the construction of 4 of the 11 Safe Motherhood Units. An important part of the project was training and seminars for local staff on "Safe Childbirth". The maternity wards are located in Yombo, Msimbasi, Kibiti and Luguruni.

AIDS programs

In cooperation with the Allamano Center, the Trentino South Tyrol region and the Autonomous Province of Bolzano, we financed a broad-based AIDS program in Iringa. Through control and prevention measures, the spread of AIDS is contained, HIV tests are carried out, HIV carriers receive antiretroviral treatment and terminal patients are cared for at home. With the support of the Happy Banking campaign of Südtiroler Sparkasse, we made it possible for the orphans registered in the project to attend school and receive medical care.


In Matembwe, in the south-east of the country, we used private donations to finance the construction of a water pipeline with a clarifier and water pumps for a village of 6,000 inhabitants.


In Tosamaganga, with the support of the Autonomous Province of Bolzano and the Trentino Alto Adige region, we made it possible to renovate and build an extension to the hospital. Tosamaganga is a missionary hospital that has been the only medical facility for many thousands of people far and wide for over 40 years.

Mikumi and Ukonga

In cooperation with the Autonomous Province of Bolzano, the renovation and furnishing of the laboratory at Mikumi Hospital was made possible. A sterilizer was purchased for the Ukonga hospital with the help of the Lions Club Maiense.