[Management of diabetic children at the University Hospital Center of Rabat: an example of partnership or personal initiative on the periphery of the school of medicine?].

In Morocco there are at least 10,000 children under the age of 15 who suffer from type 1 diabetes who, due to the lack of appropriate management and care, are extremely susceptible to repeated hospital re-admission and long-term disabling degenerative complications. With the aim to reduce the frequency of complications, a specialised outpatient clinic was created at the children's hospital in Rabat in 1986. A multi-disciplinary team provides medical care as well as initial training and continuing education to the patients and their families according to a standardised protocol. The 700 young diabetics who are monitored in the clinic are at present autonomous in the delivery of their own daily treatment and continue to increasingly improve. After 10 years, this group of patients has experienced a diabetic retinopathy rate which is six times lower than since the onset of their illness. The programme is administered in partnership and with the financial support of a private sponsor and assistance of a parents' association. The programme is designed in compliance with the WHO Towards Unity for Health strategy and its core principles, namely: relevance, equity, quality, and effectiveness. In order to achieve sustainability, the programme needs an adopted geographic management structure and more formalised relationships linking the partners. Nevertheless, the programme could be considered as a laboratory experiment for the School of Medicine, in its search to create a wider social movement. This level of commitment implies recasting the foci of the medical training curriculum, promoting therapeutic patient education, giving more attention to the hospital's operations and building sustainable partnerships.