Bangladesh is facing a double burden of communicable (CDs) and non-communicable diseases (NCDs). NCDs are increasing rapidly, while malaria, tuberculosis and other infectious diseases are still not under control. Like in many other developing countries the health care system is built around treatment and care for episodic and acute diseases and not geared to manage chronic conditions like diabetes.IDF estimates that more than 5.5 million people in Bangladesh have diabetes. This corresponds to a prevalence of 6.1%.The Bangladesh Diabetic Association, BADAS, was created to organise diabetes care throughout the country. The organisation has managed to create a large and comprehensive diabetes care model through its many affiliations and institutions. However, BADAS has so far only been able to cover 25% of the diabetic population, mainly in urban areas, with limited reach at the district level and lower.In addition to being very poor, people living in the Thanas (sub-districts) face a chronic shortage of qualified doctors. Consequently, many people residing in rural and less easily accessible areas have virtually no access to diabetes care.The aim of this project is to extend diabetes health care services to rural areas by setting up care centres through settled general practitioners at sub-district level throughout Bangladesh.
WDF has supported three other projects initiated by BADAS (WDF05-131, WDF06-193 and WDF06-195) focusing on nutrition, primary prevention, and capacity building among health care professionals respectively.This present project aims at extending diabetes care to the rural population in the Thanas (sub-districts). The project intends to get at least one physician trained in diabetes care in each of the 508 Thanas in Bangladesh. The goal is to increase the national diabetes care coverage from 25% to 50%.550 GPs from the Thanas will undergo an extensive six week capacity building course. Upon successful completion of the course they will be enrolled as BADAS accredited diabetes specialist physicians.The project will ensure provision of necessary equipment (glucometer, opthalmoscope, tuning fork and refrigerator) to the clinics of the accredited physicians.To enable proper supervision and data sharing between physicians and coordinators, an electronic network using mobile telephony will be created. The system will be linked to an existing national diabetes monitoring, supporting and managing system set up by the Telemedicine Reference Centre Limited (TRCL). It will include patient registration and a diabetes call centre manned by a licensed doctor. This part of the project is feasible because of the low-cost, high countrywide mobile telephone coverage.Besides providing diabetes care directly to patients, the project will also focus on educating family members of people with diabetes attending the accredited physician.All 500 diabetes clinics will be in rural areas. To maintain the strong poverty focus, the physician will only be allowed to charge a consultation fee that has been agreed upon with BADAS. Consultations will be free of charge for the ultra poor.
• 490 physicians from rural areas trained• 472 clinics established - all with accredited professionals• Electronic network through mobile network established