Preventing diabetes and its complications in rural areas, India

Objectives

While communicable diseases like malaria and tuberculosis are only slowly being conquered, India is today experiencing a dramatic increase in the number of people with diabetes and other non-communicable diseases.

India has the highest number of people with diabetes in the world. In addition to the number already diagnosed, an equal or even more significant number of people are expected to have undiagnosed diabetes.

Virtually all diabetes efforts in India are currently focused in urban areas. At the same time, 70% of India's population lives in rural areas. Thus, the absolute number of people with diabetes in rural areas is higher than in urban areas, and an increased focus on diabetes health care and prevention in rural areas is urgently needed.

The project aims to implement the prevention of diabetes at primary, secondary and tertiary levels in a rural area of Tamil Nadu, India.

Approach

The project covers 4 phases: In the first phase, a rural diabetes centre will be set up. Logistical issues such as workforce recruitment and equipment purchase will be addressed. Moreover, a network of stakeholders will be established, and the project will be promoted and publicized among healthcare professionals and the selected rural communities.

In the second phase, local volunteers will be educated and trained to increase their knowledge of diabetes and healthy living. The volunteers will include community health workers (e.g. school teachers and youth clubs) and village health workers (e.g. local women and self-help groups). After the training, the volunteers are expected to pass on the knowledge and skills acquired to their local communities and provide the local population with basic diabetes information.

In the third phase, screening for diabetes, impaired glucose tolerance and associated complications will be delivered at the doorstep of the rural population. A well-equipped mobile van will provide quality diabetes care to rural people who would otherwise not have access to such facilities.

Primary prevention of diabetes will be the focus of the fourth phase. It will be addressed through Information, Education and communications (IECs). Innovative approaches to increase awareness and empowerment will be adopted. These include developing low-cost information material, conducting lectures and seminars for the lay public, public awareness campaigns, nutrition workshops for rural women, and addressing target groups such as students and farmers.

Results at completion

• Awareness of diabetes and its complications were spread to the whole rural community accounting for 42 villages, 43,158 individuals with 27,014 adult population.
• 20,777 persons screened for diabetes
• 1,045 diabetic individuals participate in screening for diabetes complications
• 15 Village Health Workers (VHWs) and 15 Community Health Workers (CHWs) were trained on diabetes education and treatment
• Successful implementation of the Chunampet Rural Diabetes Model and setting up of the diabetes centre “Sai Rural Diabetes Specialities Centre”