Objectives and approach
Uzbekistan is experiencing a growing burden of diabetes and other NCDs. The most recent International Diabetes Federation (IDF) Diabetes Atlas estimates a diabetes prevalence at 7% of adult population.
Detection of diabetes and other NCDs in Uzbekistan often occurs following another health incidence e.g. stroke, loss of vision, amputation etc. which indicates a low level of capacity towards early diagnosis and detection. There are several potential reasons for this, incl low level of knowledge and public awareness.
Objectives
To support the development and implementation of a national NCD response in Uzbekistan through a strengthened primary and secondary level care outreach and through integration of NCDs into maternal care/RCH strucutres.
The WDF support to Uzbekistan is undertaken through a civil society partnership with a local stakeholder, UMID ('Charity organisation for disabled person and people with diabetes'), which collaborates closely with the Ministry of Health in all activities, whereby the programme components supported are co-implemented with the MoH at all stages. WDF provides two main grants (phase 1:WDF13-770 and phase 2:WDF16-1371); Details of phase 2 are listed below (separate website page description being prepared).
Approach
During phase 1 (WDF13-770) seminars were organized to train GPs and specialized teams in six regions targeting the improvement of primary and secondary prevention and early diagnostics of IGT and diabetes in rural population.
Diabetes screening rooms were established and equipped to become central district polyclinics in the six regions. Questionnaires for risk assessment of diabetes were developed and used by rural populations, and people detected to be at-risk with IGT and/or diabetes were referred to the diabetes screening rooms, where a trained team was trained to provide more in-depth consultations and services. Furthermore, six regional endocrine laboratories were equipped with analysers for glycated haemoglobin, microalbuminuria and lipid measurements to control for diabetes regulation in rural population with DM including early detection of IGT and DM.
A computer database of patients with IGT and DM type 2 diagnosed in the six pilot regions were set up. A specialised mobile unit was equipped to carry out screenings for IGT and DM complications in a risk group in order to compare the results obtained with people in an existing DM register.
Wider outreach activities on diabetes prevention was carried out in rural populations incl. by the development and distribution of materials concerning diabetes and NCDs, as well as through video short-films targeting rural people. Large-scale coverage through mass-media was also implemented.
Finally, regional stakeholder meetings were held aimed at the development of a diabetes/NCD prevention strategy to be adopted into a nationwide NCD response.
Results of phase 1:
50 district clinics established
840 health care professionals trained
63,000 mostly from rural communities screened and provided care and education, incl through special seminars targeting more than 6,000 people.
Phase 2: WDF16-1371
WDF grant: EUR 226,550
Grant period: 2017-2020
Through the second phase of WDF support towards the national NCD response in Uzbekistan the main focus will be on the integration of hyperglycemia in pregnancy/NCDs and pregnancy services into existing clinical structures. Endocrinologists, gynecologists and obstetricians will lead the interventions and large scale trainings will be implemented. Clinical facilities will be upgraded and electronic records installed, and antenatal/postnatal services strengthened. In parallel will awareness and education campaigns be rolled out reaching women of childbearing age and younger girls to sensitize about pregnancy and health lifestyle, hyperglcemia in pregnancy etc. The programme modality will be implemented nationwide across primary level with linkages to specialized regional clinics.
The implementation of the programme activities will continuously be undertaken under MoH Uzbekistan auspices and with UMID and other local civil society stakeholder as co-implementing agencies.
Expected results of phase 2:
- 2,400 health care professionals trained
- 12 regional integrated clinics established at referral level
- 180 primary care clinics to be provided materials and equipment
- At least 18,000 women (pregnant/child-bearing age) to be provided education, screening and care as required
- More than 400,000 women and girls reached through awareness and education campaigns
Results upon completion of phase 2:
- 2,294 doctors and specialists trained
- 12 regional integrated clinics established at referral level
- 180 primary care clinics provided materials and equipment
- 3,455 pregnant women and 18,298 women (child-bearing age) provided education, screening and care as required
- Estimated 420,000 women and girls reached through awareness and education campaigns
