More than 700 different languages and 1,000 cultural groups make Papua New Guinea (PNG) one of the most diverse countries in the world. It is also one of the least urbanised countries with 82% of the population living in rural areas. Combined with an impassable terrain, poor infrastructure and diversity make health education and health care delivery, extremely challenging in PNG.
The IDF estimates that among the 6 million people living in PNG approximately 59,200 have type 2 diabetes; yet only 4,600 people with diabetes are known to the health system. Thus, for every known case there are an estimated 12 or more unrecognised cases. Further, certain tribal groups have high prevalence rates and unhealthy lifestyle is increasingly afflicting the society.
Care is inaccessible to the vast majority of the population as diabetes service is currently only available at the main hospitals and only five nurses have been educated in diabetes care.
Approach
The implementing partners of this project are HOPE Worldwide Australia and Papua New Guinea. HOPE Worldwide is a faith-based organisation with 15 years experience of working with health, education and agriculture. Collaborating agencies include the Papua New Guinea Department of Health, the Diabetic Association of Papua New Guinea and the Cairns Base Hospital in Australia.
The project will start with the development of national treatment guideline for diabetes. The guideline will be distributed to all doctors in PNG and to 35 hospitals and 135 health centres in the country.
To increase the number of people tested, referred and investigated for diabetes and ensure proper management of the disease, 225 health care professionals from all over the country representing all 19 provincial hospitals, 7 main urban clinics in the capital city and 20 main rural health centres will be trained during a five-day workshop. The training will emphasise early diagnosis, routine care and cycle management. Each health facility represented will get a basic equipment kit and copies of relevant textbooks and journals. The Ministry of Health is committed to future supply of strips and other consumables.
Approximately 12 months after the initial training, follow-up workshops will be carried out. The workshops will consolidate and extend the knowledge and practice of the health care professionals.
To further enhance local skills, 8 key health staff from Papua New Guinea will undergo training at Cairns Base Hospital in Australia to prepare them to provide local leadership.
In order to enhance capacity and effectiveness of diabetes services currently available at the main hospitals, a number of activities will be conducted. These include a national survey of the number of patients seen and the prevalence of complications, establishment of a register, development of referral systems and provision of equipment of testing and management. The main hospital will also organise diabetes screening as well as screening for diabetes complications.
Moreover, at Port Moresby General Hospital in the country's capital, gestational diabetes services will be made available. The plan is to develop a model for gestational diabetes to gradually be implemented all over the country.
To strengthen health education a number of pamphlets with different diabetes-related themes will be produced and distributed. The pamphlets will be available in English which is the language of education and government and Hiri Motu and Tok Pisin - the two other official languages in the country. Other means of communication e.g. posters and DVDs will also be produced and distributed to diabetes patients and health professionals.
Community education programmes will be organised in high prevalence areas. The plan is to involve respected and influential members of the community as role models and educators and via small group and one-on-one education sessions promote physical activity and healthy diet. Screening will also be carried out in the communities and care will be made available for those who have diabetes. It is expected that during the project at least 30,000 people will be screened and potentially 6,000 new cases of diabetes will be identified.
With the aim of raising public awareness, activities will be arranged on the World Diabetes Day, articles will be published in national newspapers and there will be diabetes related features in the local radio and television.
