The project aims to improve the quality of diabetes care in four provinces in Vietnam (Thanh Hoa, Thai Binh, Binh Thuan and Dak Lak) through a community approach to prevention, control and management of diabetes.
Expected impact
All known people with diabetes in the target area will have access to diabetes care
60% of all known people with diabetes in the target area will be managed and self-managed effectively
80% of the population in target area (1 million people) will have a good understanding of how to prevent diabetes
All doctors and 20% of nurses in 20 district centres and 400 commune centres are trained in diabetes
Results at project completion
A baseline study has been carried out among 5,000 persons, showing a very low awareness of diabetes (77%) and of diabetes risk factors (80%).
Diabetes clinics have been established in all 8 district hospitals in the Thai Binh province. To date, 7,233 patients are being managed at provincial and district level.
The Thanh Hoa province has a new specialised endocrinology hospital and 27 district hospitals, which together manages over 6,609 patients at provincial and district level.
Diabetes education consulting rooms have been established in 28 preventive health centres in Thanh Hoa and 9 in Thai Binh.
Screening for diabetes have been conducted for 6,267 people in Thai Binh and 16,871 people in Thanh Hoa.
1,087 health care personnel from all 4 provinces have undergone training seminars in diabetes management and prevention.
Guidelines on diabetes management, prevention and clinical practice have been elaborated and printed in 7,000 copies. Additionally, instruction manuals for doctors are being developed.
Health education materials consisting of posters on diagnosis, complications, diet and exercise have been developed in Vietnamese.
Diabetes clubs have been created in both provinces, providing consultations and seminars on diabetes prevention by diet and exercise, diabetes with hypertension, foot care. The clubs experience a steady increase in members.
Diabetes information has been disseminated on province and national TV, in province radio shows and in local newspapers in Thanh Hoa and Thai Binh.
The project model has been expanded to include Binh Thuan and Dac Lac.
Project details
Since 2001, the Government of Vietnam has considered diabetes a public health problem. In 2002 the national strategy for prevention and control of non-communicable diseases was issued.
Prevention of diabetes is an important component of the national strategy.
As diabetes has only recently emerged as a severe public health problem, awareness of the disease among the public and health professionals is still low.
The level of infrastructure for managing diabetes is poor. Therefore, diabetes is treated incorrectly, in an arbitrary, ineffective way - or even not treated at all.
Objectives
The project aims to improve the quality of diabetes care in four provinces in Vietnam (Thanh Hoa, Thai Binh, Binh Thuan and Dak Lak) through a community approach to prevention, control and management of diabetes.
The project has the following main objectives:
Raise awareness of diabetes at community level
Improve clinical knowledge and skills among medical staff involved in diabetes treatment
Educate people with diabetes in self-management
Find new cases of diabetes
Set up a diabetes association at national and local level
Approach
The project builds on an existing collaboration between the Ministry of Health (MoH) in Vietnam and the regional office of the World Health Organization for the Western Pacific (WHO/WPRO). The Endocrinology Hospital is the key partner in Vietnam.
The project will be applied in 2 demonstration provinces, involving 20 districts, 400 commune centres and a population of around 1 million people. If the project proves successful, the model may be used throughout Vietnam.
A baseline survey was carried out nationally in 2002 focusing on diabetes, its risk factors, the capacity of medical staff and awareness of prevention of diabetes among people with diabetes and local communities.
The baseline survey will be supplemented by a data collection on the incidence of diabetes and diabetes control in the 2 provinces as part of the development of the final detailed design of the project implementation phase.
The implementation phase focuses on activities such as:
training of medical staff
educating people with diabetes
enhancing community awareness of diabetes, its prevention and complications
setting up a diabetes association nationally and locally
detecting new cases
establishing a system for managing diabetes systematically and effectively
At the end of the project, the outcome will be assessed in order to determine the suitability of the model for possible replication throughout Vietnam.
