Projects

Scaling up diabetes care for Palestine Refugees in the Near East WDF11-614

WDF11-614
The project aims at improving diabetes care for Palestinian refugees in 131 UNRWA clinics in five fields in the Near East.

Objectives & approach

Treatment and care of communicable diseases used to be the main activities in United Nations Relief and Works Agency for Palestine Refugees (UNRWA) clinics in the Palestine Occupied Territories. Epidemiological transition in the region due to changing lifestyle, nutrition and stress is changing the work of UNRWA and it is now faced with the challenge of providing treatment and care of non-communicable diseases to millions of refugees. According to the International Diabetes Federation, 8,6 % of the population in the Palestine Occupied Territories have diabetes but the situation on the ground is actually much worse with figures as high as 12 to 15% being mentioned. Without a comprehensive strategy to address care and prevention the health and economic consequences are likely to be very high.

Diabetes, obesity and hypertension are increasing at a rapid pace putting the existing resources at the UNRWA clinics under a lot of strain. Adding further to inadequate care and poor outcomes is the fact that most health staff are largely educated as generalists with limited education in diabetes treatment and care. This situation calls for evaluation of quality of care and the skills and training needed to improve outcomes and provide the staff with the necessary training. Furthermore, the rising burden also requires outreach activities to address awareness, prevention and early detection at the community level.

Objective
The project aims at improving diabetes care for Palestinian refugees in 131 UNRWA clinics in five fields in the Near East.

Approach
United Nations Relief and Works Agency for Palestine Refugees (UNRWA) is initiating this project in Lebanon, Jordan, Gaza and the West Bank. This project is the first WDF-funded project with activities in Lebanon. UNRWA has previously initiated the WDF10-555 project in Gaza and the West bank aiming at improving diabetes care and management of the diabetic foot. This project will expand the awareness activities to other Palestine refugee camps in Lebanon and Jordan.

Three main activities will contribute to an increased awareness of diabetes and better care for people with diabetes: clinical auditing of diabetes care, training of health care personnel and awareness campaigns.

The project will be initiated with collection of information on the current quality of diabetes care. Data from 100 people with diabetes from each health care centre will be analysed and the knowledge obtained through this activity will guide UNRWA clinics in the improvement of diabetes care. The gained information will serve as a baseline for future evaluations.

Additionally, knowledge and skills of the staff will be assessed to identify deficiencies and needs for training. UNRWA's own technical guidelines for diabetes care together with internationally recommended diabetes care guidelines and training resources from e.g. World Health Organisation and International Diabetes Federation will be applied in the training.

Focused, comprehensive training for doctors and nurses, who will assume key functions in diabetes care in UNRWA clinics, will be accomplished. A two-week training session will be conducted in the second and third year for a team consisting of three doctors and three nurses from each of the five fields. The training will focus on comprehensive diabetes care and on practical teamwork between doctors and nurses. The teams of health care workers will be trained as Trainers of Trainers (ToT) and will in immediate continuation of their own training conduct training sessions for a total of 156 doctors and nurses.

In order to improve knowledge of diabetes, two awareness camps will be organised each year in three of the five fields (Jordan and Lebanon). Increased awareness in Gaza and the West Bank is already being covered from similar activities in the WDF-funded project WDF10-555. The campaigns will last for two to three weeks and include awareness activities for two days. The campaigns will address lifestyle issues related to diabetes and keep a focus on early detection. The activities will consist of health education, screening of targeted population and referral of people with diabetes to specialised clinics. The campaign activities will be organised in already existing institutions like women's centres, youth centres, religious institutions, UNRWA schools and other public places.

31 official refugee camps with a total of 700,000 people is expected to benefit from the campaigns. The target population of the awareness camps are the Palestinian refugees registered with UNRWA, but national citizens residing near the refugee camps would be welcome to join the awareness activities to receive health education and screening for diabetes.

Expected results
• 40 clinics audited and 20 clinics re-audited to assess improvements
• 30 doctors and 30 nurses trained as trainers in comprehensive diabetes care
• 78 doctors and 78 nurses from UNRWA clinics trained on-the-job in diabetes
• 12 community campaigns conducted in 3 fields (Jordan and Lebanon)
• 62,000 people screened for diabetes 

Project information

Project nr.: 
WDF11-614
Project Status: 
Completed
Interventions and focus areas: 
Primary focus area: 
Region: 
Middle East and North Africa
Country: 
Jordan, Lebanon
West Bank and Gaza
Partners: 
UNRWA
Project responsible: 
Dr. Akihiro Seita
Project period: 
2011
Project budget: 
USD 3.773.758
WDF contribution: 
USD 419.043,51

Expected results
• 40 clinics audited and 20 clinics re-audited to assess improvements
• 30 doctors and 30 nurses trained as trainers
• 78 doctors and 78 nurses from UNRWA clinics trained
• 12 community campaigns conducted in 3 fields 
• 62,000 people screened for diabetes