Background

According to the International Diabetes Federation (IDF) the prevalence of diabetes (type I and type II) in Armenia is 7.2% in adults. Armenia is implementing a strategy to prevent diabetes and improve care for diabetes patients. Unfortunely the strategy plan does not anticipate any specific action on diabetes-related eye diseases. Armenia is one of the least developed countries in Europe and access to health care (incl. diabetes care) is uneven across the country leaving some areas underserved in terms of access to care. By implementing prevention and screening programs the Armenian EyeCare Project ( AECP) hopes to contribute to bridging this gap in terms of diabetes care. 

Objectives

To improve access to Diabetic Retinopathy (DR) screening and care for type 1 and 2 diabetes patients in underserved areas of Armenia.

Approach

The intervention is aimed at preventing the need for complicated surgical eye treatments for diabetes patients. This program will enable the partner to identify diabetes-related eye diseases at an early  stage which will result in better outcomes for the patient and contribute to the prevention of blindness caused by diabetes-related eye diseases.

The quality of care will be enhanced through capacity building at  primary and secondary level. Health care personnel incl. doctors, nurses, endocrinologists and ophthalmologists from all regions of Armenia will receive training on diabetes and diabetes eye care.

The quality of care will also be enhanced through the upgrading of equipment incl. ophthalmoscopes and smartphone devices at primary level for outreach activities; fundus cameras and lasers installed at regional eye care clinics to provide better treatment.

Detection of patients with retinopathy will be improved through roll out of routine DR screenings in primary clinics by regional ophthalmologists and roll out of screening camps in underserved, poor villages in each region; known DM patients and at-risk patients will be referred to DR screening.

Detected cases will be referred for care and follow-up at regional eye clinics or mobile eye clinics. Specialised care incl. laser and surgery to be provided in the regions.

Sensitisation and awareness will be enhanced through training of Community Health Workers as diabetes educators, and advocacy and awareness raising events to promote inclusion of diabetes eye care into national diabetes strategy.

Expected results

• DR screening and care established/strengthened at 87 clinics, incl.  primary clinics, regional eye clinics, and mobile clinic
• 100 endocrinologists, 100 ophthalmologists, 400 family doctors and 400 nurses have enhanced knowledge in diabetes and eye care
• 50,000 persons (incl. known diabetes patients and at risk-group) screened for DR and 8,000 referred for detailed examination and care; 300 patients treated with laser and 200 treated with surgery
• 10,000 patients and at-risk persons enhanced knowledge in prevention and self-management by 150 CHW trained as diabetes educators

Results upon completion

• DR screening and care established/strengthened at 87 clinics, incl. primary clinics, regional eye clinics, and mobile clinic
• 536 doctors (endocrinologists, ophthalmologists & family doctors) and 427 nurses trained in diabetes eye care
• 52,386 persons (incl. known diabetes patients and at risk-group) screened and 16,000 screened with DR photo imaging; 1,229 patients treated with laser and 300 treated with surgery
• 8,000 patients and at-risk persons trained in prevention and self-management by 234 HCPs trained as diabetes educators