Improving integrated diabetes support in Madagascar, WDF15-1321

Objectives

1. Strengthen the health system within the A.MA.DIA
2. Strengthen diabetes care in public health centres
3. Increase awareness of diabetes and detection of patients
4. Develop a pilot patient registry

Approach

Improvement of access to diabetes care will be done through establishment of new diabetes clinics in ten regions not previously targeted by A.MA.DIA, including provision of equipment and training of doctors in diabetes care and education. Regional health authorities will be involved in the selection of clinic sites and appointment of doctors. Clinics will be operated on non-profit basis by A.MA.DIA but be integrated with public diabetes care and referral system. Clinics will be provided ongoing mentoring and technical support by A.MA.DIA, incl. through the use of telemedicine. An electronic registry will be piloted at five A.MA.DIA clinics.

CHWs of the targeted new regions will be trained in basic screening for diabetes and assessment of risk factors.Diabetes care in the 12 regions targeted through WDF09-428 will be consolidated, incl. re-training of doctors from A.MA.DIA clinics.

Awareness of diabetes will be raised and increased detection of patients will be done through implementation of screening camps and radio campaigns in all 22 regions of the country, and through sensitization of parliament, ministries, traditional leaders, and others.

Doctors from public and private health care facilities in various regions will be trained within basic diabetes care. Trained doctors will be provided screening equipment and serve as diabetes focal points for diabetes screening and management in their respective area.

Additional HCPs in all regions will be sensitised on detection of diabetes risk factors and on the existence of A.MA.DIA clinics. New focal points and a referral system for diabetes patients will be developed, where patients are either referred to focal points, or to A.MA.DIA clinics if more advanced care is needed. Patients with severe complications will be referred to regional hospitals or A.MA.DIA’s main diabetes centre in the capital.

Expected results

• A.MA.DIA diabetes clinics established in ten new regions
• MoH diabetes services established at 30 public health centres and 60 private clinics across Madagascar
• 140 doctors trained
• 600 HCPs trained
• 130 CHWs sensitised.
• 150 screening camps held
• 30,000 people screened for diabetes
• At least 1,500 new cases of diabetes diagnosed
• 2,500 diabetes patients registered at new A.MA.DIA clinics
• All 22 A.MA.DIA clinics register up to 50,000 patients by the project’s end