The project aims to implement a diabetes prevention and control programme in rural and semi-urban areas of India.
Expected Impact
An estimated 100 hospitals affiliated with the Christian Medical Association of India will participate in and benefit from the capacity building of the project. 200 doctors from these hospitals will be trained.
75 podiatrists will be trained to improve foot care
200 nurse diabetes educators will receive training to improve the quality of diabetes education
Results at project completion
100 clinics have been established / strengthened in CMAI affiliated hospitals and 4,531 patients treated.
288 doctors, 196 nurses and 38 paramedics have been trained in foot care.
194 screening / awareness camps have been held screening 7,799 people.
675 people have been screened for diabetic foot.
A "Diabetes Manual" for doctors, a "Diabetes Health Manual Booklet" and a CD containing all the training material have been produced. The fourth edition of "A Practical Guide to Diabetes Mellitus" was released in July 2008.
Since 2004, CMAI has commemorated the World Diabetes Day each year and organised an entire diabetes awareness week including quizzes for medical students, poster/essay/painting/song/dance competitions, a walk-a-thon as well as awareness and screening camps.
Project details
Urban prevalence of diabetes in India is almost 12 percent - rural prevalence is "only" 3 percent. But with 75 percent of India's population residing in rural areas, a large number of people with diabetes require qualified care outside of the urban areas.
Developing a national programme for prevention and control of diabetes for India is an enormous task. The first steps have been taken by the Government of India with the identification of an expert committee chaired by Prof. Ramachandran at the Diabetes Research Centre in Chennai.
In recognition of the fact that the task at hand is enormous, the Government of India is looking towards the private sector and non-governmental organisations to partner with them to evolve and implement an effective and feasible programme. This project is one step in that direction.
Approach
Three partners have come together to address the problem of diabetes care delivery in rural and semi-urban communities through a collaborative effort. The partners are: Christian Medical College (CMC), Christian Medical Association of India (CMAI) and Schieffelin Leprosy Research and Training Centre (SLR&TC); all situated in Vellore, India.
CMAI have over 350 affiliated mission hospitals distributed throughout India, but mainly in the North, where government and private sector services are unavailable. These hospitals provide care at a reasonable cost, affordable to the poor.
CMC is one of the oldest and most recognised medical colleges in India. It has 1800 beds and functions as referral hospital for the CMAI hospitals.
SLR&TC brings internationally recognised expertise in the area of foot ulcers, one of the most debilitating complications of diabetes.
The project focuses on four key areas: Community education, capacity building among doctors at CMAI hospitals, training of nurse diabetes educators and provision of improved foot care, including training of podiatrists and production of appropriate footwear.
In the area of community education the project seeks to educate the community as a whole but targets special groups in the awareness programmes, including high schools, industrial workers, self-help groups and the leaders of the panchayats. Educational methods include pamphlets, posters, small group discussions and cultural groups of youth performing street plays to spread the message. 20 CMAI hospitals will participate in the community education activities.
Capacity building will take the form of training of doctors, nurses and podiatrists to improve the quality of care offered at the CMAI hospitals. Doctors will be trained for 3 days at CMC. The training programme for nurses will be of 2 weeks' duration. The aim is to encourage self-care and reduce hospital visits and admissions. The podiatric training will be of one-year duration. An in-take of 15 students per year is expected.
Apart from training podiatrists the project also focuses on the provision of suitable and affordable footwear to people with diabetes. Experience shows that ulcers recur due to use of inappropriate footwear or lack of footwear. Orthopaedists will be trained in the production of footwear using micro-cellular rubber, used for the prevention of ulcers.
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