The aim of the project is to create early detection and management of gestational diabetes in the Indian state Karnataka.
Expected impact
5,200 pregnant women will benefit
25 health workers trained
11 health facilitators trained
30 doctors trained
60 nurses and paramedics trained
100 accredited social and health activists (ASHAs) trained
50 auxiliary nurse midwifes trained
100 anganawadi workers and 50 members of governance structures and NGOs trained
Results to date
25 doctors have been trained.
121 nurses have been trained.
780 paramedics have been trained.
1,053 awareness activities (street plays and village meetings) have been conducted.
163 screenings camps have been conducted, screening 239 women with the glucose challenge test (GCT).
An estimated 61,000 people have been reached by the awareness and screening activities.
256 clinics have either weekly or bi-weekly GDM clinics. 2,304 women have been screened for GDM.
Project details
Diabetes is a major public health problem in India. More than 50 million people in India are currently suffering from diabetes and the number keeps growing. Hence, it has been projected that by 2030 around 87 million people will have diabetes.
Women who get gestational diabetes are at increased risk of developing type 2 diabetes after their pregnancy and so are their children. However, if properly monitored these risks can be significantly reduced.
In addition to the increased risk of type 2 diabetes, gestational diabetes may also result in the baby being born large for gestational age which increases the risk of complications during delivery and ultimately poses a threat to the life of the mother and child.
In India, a 16.8% prevalence of gestational diabetes in urban and 10.8% in rural areas has been reported. Yet, many women are never screened for gestational diabetes and their condition is therefore not monitored; thus, their risk of type 2 diabetes and birth complications remains high.
Approach
The implementing partner is Swami Vivekananda Youth Movement which is a voluntary, social service organisation working in Karnataka State. The organisation runs two hospitals geared to provide primary and secondary level health care to the predominantly rural community.
The project combines hospital based care with community based primary care in order to detect gestational diabetes early and ensure proper management of the disease.
Initially, the project will train 25 community based health workers on health promotion and education, maternal and perinatal monitoring and gestational diabetes and its management. The training will be of three months duration and include both lectures and field based training.
In their future tasks the health workers will be supervised by health facilitators. In order to ensure that these health facilitators are sufficiently knowledgeable about diabetes, an orientation workshop on gestational diabetes and its management will be arranged.
Upon completion of training, the health workers will go from door-to-door in villages and explain the inhabitants about the project. They will also identify pregnant women and women who might become pregnant and collect demographic data from them. Risk factors for gestational diabetes will also be reported. The health workers will refer pregnant women to the hospital for screening for gestational diabetes and motivate them to attend antenatal care.
It is expected that a total of 5,200 pregnant women will be screened. If women are diagnosed with gestational diabetes, a customised management plan will be provided. The health worker will then - under supervision of the health facilitator - work with the woman and encourage and help her bring her diabetes status under control.
The women will also be encouraged to deliver at a hospital. Throughout the pregnancy and postpartum the health of the mother and infant will be monitored to ensure that complications do not arise.
In addition to the identification, screening and monitoring of pregnant women, health promotion messages will also be conveyed. Both the pregnant women and the women who are not pregnant will receive information about reproductive health including HIV and STDs, diet and nutrition, lifestyle changes and prevention of diabetes.
The health facilitator will arrange monthly meetings for people with diabetes to facilitate discussions of their problems and sharing and learning from one another. Community meetings where health promotion messages are given to the general population through street plays, audio-visual sessions etc. will also be conducted.
In order to ensure proper health care delivery to women with gestational diabetes, orientation workshops on gestational diabetes will also be carried out for 30 doctors and 60 nursing and paramedical staff. Furthermore, 100 accredited social and health activists (ASHAs), 50 auxiliary nurse midwifes, 100 anganawadi workers and 50 members of governance structures and NGOs will be briefed to warrant successful implementation of the project.
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