The prevalence of Diabetes in the Palestinian population in the West Bank, Gaza and E. Jerusalem is high in the range of 15.3% (published) compared to a worldwide prevalence of 6%. , however, anecdotal information from numerous sources suggest the rate could be much higher (18-21%). Of the total diabetic population in Palestine, 4.4% of persons are diagnosed with type 1 diabetes, 95.3% are diagnosed with type 2 diabetes.
1. Upgrade 3 model centres located in the northern and East Jerusalem districts to act as referral centres utilizing the DCCM (Diabetes Comprehensive Care Model) and implementing Gestational Diabetes Mellitus (GDM) protocols and upgrade six (6) strategically located intermediate level clinics.
2. Strengthen the national committee of non-communicable diseases to be active and operational.
3. Build capacity of health care providers, (doctors, nurses, school and community health workers) to implement national protocols to strengthen diabetes care and prevention including life style counselling.
4. Provide diabetes patients with consistent comprehensive care, management and screening for diabetes-related complications through and in coordination with partners, community health clinics & mobile clinic.
5. Raise awareness of preventive measures for diabetes/other NCDs within communities/schools.
Programme is considered integral to PMoH national diabetes care and prevention programme. Activities include:
1. Strengthening of the National Committee on NCDs incl through enhanced participation of all project partners.
2. Upgrading of model centres (to become referral centres and centres of excellency) and strategically located intermediate level clinics through stronger adherence to existing protocols and through provision of equipment.
3. Capacity building of HCPs and CHWs through practical training programmes (based on existing national guidelines and WHO-PEN) concerning implementation of national protocols to strengthen diabetes care and prevention; including life style counselling, the use of GDM protocols, foot and eye care; incl. establishing of referral mechanisms.
4. Provision of comprehensive care and diabetes education; screening and referrals of related complications incl. specialized treatment/counselling in coordination with partners, community health clinics and mobile clinic
5. Rollout of awareness-raising and screening campaigns within schools and communities through media, IEC materials, group counselling and biometric screenings.
6. Implementation of a monitoring and evaluation framework at all levels of the intervention; incl. clinical reviews of registered patients; M&E framework to include calculations on health economic benefits.
• Three model centres (two MoH and one UNRWA) upgraded.
• Six intermediate level clinics (four MoH and two UNRWA) upgraded.
• 272 HCPs and 75 CHWs trained.
• 34,000 diabetes patients with improved access to care; 750 GDM patients treated; 2,000 diagnosed with retinopathy and treated; 5,000 diagnosed and treated for foot complications.
• Estimated 1.2 million people reached through awareness activities.
• 14,500 diabetes patients from refugee population registered.
• 10,000 high risk population screened for diabetes; 3,000 students to have participated in awareness campaigns and prevention activities.
• M&E system for diabetes care/prevention established incl enrolment of registered patients and incl clinical indicators; A health economics component also to be developed.
1: Abu-Rmeileh NME, Husseini A, Capewell S, et al. Preventing type 2 diabetes among Palestinians: comparing five future policy scenarios. BMJ Open 2014;3: e003558. doi:10.1136/bmjopen-2013-003558