Objectives & approach
Occupied Palestinian Territories (OPT) is experiencing a rising diabetes-prevalence currently estimated at 6.4%. Due to the political and economic instability as well as the rapid increase in diabetes-prevalence, health care in general and care for chronic diseases like diabetes in particular have not received adequate attention from the authorities. The fragmented and poorly resourced health care system operates in a continuous state of crisis and emergency and there is limited access to qualified diabetes care, management and prevention.
Despite these ground realities, progress towards increasing access and improving quality to diabetes care has been made. In 2003, DanChurchAid (DCA) and the Augusta Victoria Hospital (AVH) initiated a diabetes project in Gaza and the West Bank with support from WDF. An essential element of the project was the establishment of a diabetes centre at AVH, combining diagnostics, medical treatment, nutrition counselling, prevention and foot care and subsequently developing outreach programs. These first steps have helped towards building a comprehensive holistic approach to diabetes care in Gaza and the West Bank. However, much more needs to be done throughout the area.
The overall aim of the project is to facilitate comprehensive diabetes care and prevention throughout the Palestinian health sector.
The aim of this new joint DCA /AVH effort is to provide a comprehensive holistic approach to diabetes prevention, treatment and management throughout Gaza and the West Bank. This current project seeks to standardise and expand former interventions and builds upon the two WDF-supported projects WDF06-170 and WDF07-264 which have provided comprehensive diabetes and gestational diabetes (GDM) care to 25 UNRWA clinics. The aim is to expand coverage to all of OPT, and to secure commitment from the Palestinian public health care system. The project employs a multi-partner approach involving Juzoor Foundation for Health and Social Development, the Palestinian Ministry of Health (MoH), The United Nations Relief and Works Agency for Palestinian Refugees (UNRWA) and other NGOs working in the field of diabetes.
The project has three main objectives:
1. The first step is to collect all diabetes-related health care protocols currently being used in OPT to review current practices. It is the intention to reach consensus for one single uniform national protocol for diabetes care that will be implemented throughout the Palestinian health care system in collaboration with both public and private providers.
2. The project wishes to increase the number of primary care clinics with basic equipment to implement and incorporate GDM protocols especially in the rural clinics not able to provide proper GDM care or screening due to a lack of technical capacity and know-how. A core training team consisting of a group of health care professionals and community specialists will be established for the purpose of introducing and implementing GDM protocols into approximately 100 MoH as well as UNRWA- and NGO-run clinics in the West Bank. They will conduct capacity-building of the clinics and will continuously follow up to ensure effective uptake of the protocols. This is crucial, especially in rural areas where adoption of the protocols can be tricky due to cultural, traditional, social and/or religious barriers.
3. The final objective of the project is to establish a model central referral clinic within the public health care system in the Hebron district of the West Bank. The clinic will act as a resource centre accessible to all health care providers. As DANIDA has funded the establishment of a model clinic within the UNRWA system, this approach ensures that the two main health care providers in the country are targeted, thereby creating a basis for reaching the whole population. Furthermore, the project will carry out capacity building for individual health care workers by conducting training events, conferences etc. In addition, the project will continue to strengthen the role and capacity of the Augusta Victoria Hospital as a centre of excellence. The hospital is envisioned to become a state of the art central referral centre with an advanced lab and diagnostic facilities for more complicated diabetes cases, particularly for management and salvage of the diabetic foot and a centre for ongoing capacity building of health workers in OPT.
• Existing diabetes and GDM protocols revised
• 400 doctors, nurses and lab technicians from 100 clinics trained in revised diabetes and GDM protocols
• Establishment of a central referral clinic for the Ministry of Health in the Hebron district
• Continued development of the Augusta Victoria Hospital Diabetes Care Centre for referrals and specialised training
• 6,500 diabetes patients sensitised on diabetes
• 3 national diabetes conferences with 300 direct beneficiaries conducted
• 5,000 pregnant women targeted for early diabetes detection and GDM management
• 2,000 patients and 12,000 family members reached through the model clinic in Hebron for improved diabetes care
• 900 public health care professionals from 450 primary care clinics gain increased knowledge of diabetes care
• 200 maternal health care providers will benefit from using the revised GDM protocol
• 750 clinics throughout the West Bank directly or indirectly strengthened for providing diabetes services
• 24 organisations will benefit
• A total of 30,000 diabetes patients will have benefitted from improved care