The burden of preventable diabetes complications in Pacific Island countries is disproportionately high, resulting in untold personal suffering and untenable financial costs to the countries. Diabetes prevalence is expected to be between 12 and 20% of the adult population. With their relatively small populations, Nauru and Vanuatu cannot support the required specialist healthcare services, often relying on experts from abroad or sending patients to Australia or New Zealand at a high cost.The project seeks to improve the quality, accessibility, and effectiveness of diabetes care, thereby reducing the burden of diabetes complications in Nauru and Vanuatu.
This project centres on secondary and tertiary prevention of diabetes complications through service and systems development and capacity building, with particular emphasis on primary care and referral networks. The aim is to design and implement a locally relevant and sustainable model to increase the capacity of Nauru and Vanuatu to manage, monitor, and improve diabetes care, reducing eye, kidney, and foot complications resulting from diabetes.In addition to building specialist capacity in diabetes complications, the project focuses on building effective systems for appropriate diabetes care and management to help many people with diabetes avoid developing complications.The project design and workflow will follow a "Measure the status quo - Develop the model - Make a difference - Measure the difference" method. 1. Assessment: As the first stage, the existing level of diabetes care and services will be assessed in the two countries.2. Model Development: The assessment will be followed by developing a suitable model based on internationally recommended standards of care, delivering optimally effective diabetes care that is locally relevant and feasible in a Pacific Island setting.3. Implementation: Making a difference will focus on introducing the systems identified, equipping the services, and training the healthcare staff in clinical management, patient education, and services management. This stage will also focus on the maintenance and monitoring of the systems, including review and adjustment to ensure the consolidation of an appropriate and effective model.At the end of the project, the baseline assessment will be repeated to measure the difference made by the project activities.Several institutions have agreed to contribute towards the implementation of this project, including the Ministries of Health in Nauru and Vanuatu, the International Centre for Eyecare Education, the Australian and New Zealand Society of Nephrologists, and the Diabetes Unit - Australian Health Policy Institute. International institutions donate staff time and clinical attachments in Australia to train healthcare staff from the two target countries. Furthermore, Novo Nordisk staff in Japan is co-funding the project.
- Access to laboratory equipment, reagents and consumables required to measure blood glucose and lipid control is more reliable - Improved foot care and a trend towards a decrease in amputations and increased debridement could suggest earlier detection and improved treatment of foot problems - Fewer diabetes related admissions and an increase in average length of stay suggests improved diabetes care provided at the local level, with only serious cases referred to hospital - Local staff increasingly competent in diabetes care and project management