As a consequence of globalisation and urbanisation, many countries are facing the burden of both infectious diseases and non-communicable diseases (NCDs).The Solomon Islands are no exception; they are undergoing rapid socio-economic and epidemiological transition and are currently faced with the double disease burden.Diabetes is the leading cause of admission to the National Referral Hospital (NRH) in Honiara, Solomon Islands. The Diabetes Centre at the NRH receives 40 patients daily and with only two nurses and one doctor available two days a week, there is not enough time for each patient for adequate examination and education. Furthermore, the clinic severely lacks equipment, supplies, material and resources for staff training and patient education. This leads to poor knowledge on diabetes self care, inadequate treatment and poor outcomes with patients more likely to develop severe complications like cardiovascular diseases, renal disease, impaired vision and amputations of lower limbs.The projects seeks to establish a national diabetes and NCD plan and thereby reduce risk factors for diabetes and other NCDs, prevent or delay the onset of diabetes complications and strengthen the health care system.
The Diabetes Unit - Menzies Centre for Health Policy and the University of Sydney Institute for Sustainable Solutions - Health Stream has taken the initiative to implement this project based on funding support from the WDF. The other collaboration institutions who have agreed to contribute are the Ministry of Health - Solomon Islands (MoH), Australasian and New Zealand Society of Nephrologists, International Centre for Eyecare Education and Institute of Obesity, Nutrition and Exercise.The project will be implemented with focus on two arms; a care arm and a prevention arm. It will follow a "Measure - Model - Make a Difference - Measure the Difference" approach, which also was used in WDF06-176.The focus of the care arm will be on training of health care workers and strengthening of hospitals and clinics.In order to provide health care staff with optimal training, a baseline assessment covering the current status of diabetes care, diabetes services and a needs analysis will be conducted. This will among others include an examination of the known risk factors for diabetes, what kind of clinical processes and practices work best to prevent complications, potential barriers to healthy living, existing health policies and how good practices can be adapted to the Solomon Islands. This will result in a model for delivering optimal diabetes care and prevention specially designed to the Solomon Islands.Local staff consisting of village health workers and specialists will receive training in diabetes care and prevention. They will further be educated in project management and organisation to ensure that the new practices continue after project completion. Training will be based on training material developed for Tonga, Vanuatu and Nauru (WDF06-176), which was completed successfully.The major focus of the prevention arm will be on making the healthy lifestyle choice available, affordable and easy to access. This will be obtained by changing the physical activity and food environment and by reducing the inhabitant's intake of tobacco and alcohol. In order to obtain these goals, MoH will be involved in engaging with other government portfolios and the private business sector to change attitudes, policies, regulation, urban development, food production and trade practices in the local setting.At the end of the project the baseline assessment will be repeated to be able to measure the difference made by the project activities. The project will end up in a national diabetes and NCD plan.
• 22 doctors trained in diabetes prevention and care• 553 nurses trained in diabetes prevention and care• Awareness campaign conducted• Stakeholder forum conducted