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Even though the Diabetic Association of Bangladesh (DAB) is providing organised diabetes care to about 1 million people, approximately 80% of people with diabetes in Bangladesh do not receive organised health care.
Moreover, the number of people with diabetes is expected to increase rapidly in the coming decades due to lifestyle and other changes associated with urbanisation. This increase will require more capacity, something that is already lacking. Especially physicians are scarce and so DAB has decided to emphasise the role of para-professionals, particularly diabetes educators.
Objective
The project seeks to improve management of people with diabetes through well trained diabetes educators.
Approach
The partner, the Diabetic Association of Bangladesh (DAB) has a nationwide network of diabetes health care organisations and is now planning programmes to improve diabetes care and prevent complications.
The project builds upon two other WDF funded projects, namely "Improving nutrition education" (WDF05-131) and "Primary prevention of diabetes" (WDF06-193).
The evidence-based tools on nutrition developed by the first projects and the strategies regarding community level manpower developed by the second project will be very useful to the trained diabetes educators from this present project and further strengthen primary prevention of diabetes. So, the diabetes educators will provide the link between clinical service and a community based preventive and health promotion approach.
The objective is to make the present health care services provided by DAB more comprehensive through the following activities:
- Development of training curricula and materials for diabetes educators
- Training of diabetes educators and in-house trainers
- Assessment of the impact of services delivered by diabetes educators
- Modification and improvement of the training materials based on the assessment
These activities will be implemented in 3 phases.
During the first phase collection and compilation of national and international curricula, literature and training materials will take place as well as adaptation and improvisation of draft curricula and training strategies.
In addition, 100 candidates will be recruited to participate in the training programme to become diabetes educators. Each training programme will last for 1 month and train 25 candidates. The main focus is on skills and knowledge. After completion of training, the diabetes educators are expected to improve the comprehensive care approach emphasised by DAB by providing people with diabetes self care education.
During the training of the diabetes educators, 20 candidates will be selected as potential in-house trainers (ToT) and will then undertake a second intensive 1 month training programme. The training of ToTs will take place during the second phase of the project.
The training programme will include more in-depth theoretical and practical inputs with emphasis on teaching and communication skills and techniques, which should enable the ToTs to provide training not only to patients and the public but also to fellow health care workers.
This means that even though the present project trains 100 diabetes educators, it is expected that at least 800 diabetes educators indirectly will be trained within 3 years, due to the training of ToTs, who will continuously provide on-job education and training to nurses, nutritionists and health educators from DAB projects and affiliated associations.
The impact assessment of the diabetes educators will also be carried out during the second phase of the project.
In the third and final phase, the draft curriculum, training tools and strategies will be modified based on the assessment. Furthermore, a workshop will be conducted and an outline for a National Diabetes Education Programme will be developed.
Expected impact
- 80 diabetes educators trained
- Training of 10 in-house trainers (ToT) to provide on-job education and training of nurses, nutritionists and health educators
- 304,000 people with diabetes educated by the diabetes educators
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