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Diabetes is a major cause of morbidity and mortality in Latin America and the Caribbean. According to the World Health Organization, the number of people with diabetes in the region is expected to increase from 35 million in 2000 to 63 million in 2025.
Insufficient control and management of diabetes is associated with serious complications. Morbidity and mortality due to these diabetes-related complications could be reduced by improving glyceamic control of people with diabetes.
In Latin America and the Caribbean, diabetes control needs to be improved. Important elements in this aspect are to provide people with diabetes with proper care and high quality diabetes education.
Objective
The project aims to improve quality of diabetes care by developing and implementing evidence-based diabetes guidelines as well as a diabetes care improvement programme.
Approach
The project is a joint initiative between the Pan American Health Organization (PAHO) and Ministries of Health, diabetes associations and the scientific society of the participating countries.
The project builds on three components, which complement each other in order to reach the common goal of improved diabetes care and improved quality of life of people with diabetes.
Firstly, evidence-based diabetes guidelines will be developed and implemented. The purpose of the guidelines is to standardise clinical practice at national level and ensure that all patients receive optimal and evidence-based diabetes care.
Secondly, a programme for improving diabetes care will be implemented. A one-year intervention project will be conducted in at least 3 primary care clinics in each of the four participating countries - a similar number of clinics will participate in the project as control clinics. At the intervention sites, people with diabetes will benefit from different activities such as establishment of support groups, training of health care providers and the use of health promoters to increase effectiveness of diabetes education.
Finally, a diabetes education programme will be developed aiming at improving patient self-management of diabetes. The programme will be tested on people with diabetes from different cultural and socio-economic backgrounds in order to guide the final version of the education programme. Educational material will be produced with special emphasis on people with low education.
Expected impact
- Evidence-based diabetes guidelines developed and implemented
- 150 health care providers will participate in educational programme
- 1,200 people with diabetes (300 per country) will participate in the quality improvement intervention through their attendance at intervention clinics
Results to date
- At a sub-regional workshop held in Panama City November 2006, 35 participants from the participating countries discussed the establishment, implementation, and evaluation of evidence-based guidelines
- National technical committees have been formed in Nicaragua and Guatemala and are under establishment in Honduras and El Salvador
- A manual for intervention has been developed and reviewed by the country teams and adapted to the local situations
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