Despite the Government’s focus to reduce the risk factors at a societal level non-communicable diseases (NCD) like diabetes are rising in Bhutan and account for an increasing share of the national disease burden.In an attempt to decrease the rapidly growing number of people affected by diabetes, the Ministry of Health (MoH) has recognised the need for creating awareness and care for the increasing number of people at risk or people already diagnosed with diabetes.The aim of the project is to extend and strengthen diabetes care by enhancing prevention and specialised care for diabetes and related NCDs in all districts of Bhutan.
This new project is an extension of the previous project WDF03-060 initiated in Bhutan in August 2004. The implementation of WDF03-060 has resulted in compilation of baseline data on NCD prevalence in the country, which has lead to changes in policies and an increased focus on the care of people with diabetes. This new project will also be coordinated by the Department of Medical Services at the Ministry of Health.Already existing diabetes clinics will be further strengthened, while new clinics will be established in hospitals with no existing diabetes care units. In total, 20 districts hospitals will get a functional diabetes clinic. The clinics are expected to provide care for people with diabetes and provide early screening for complications in order to delay or prevent severe complications.In order to strengthen maternal and child health services and address primordial prevention of diabetes and related NCDs, 30 antenatal clinics in each of the 20 districts will receive education and training for performing screening of gestational diabetes mellitus (GDM) on all pregnant women visiting the clinics. GDM can lead to high blood pressure, preterm delivery and a general increased risk of complications during pregnancy and delivery. By setting up antenatal clinics, a great number of women will be screened for GDM early in pregnancy to decrease the risk of complications during pregnancy and delivery as well as address future prevention of diabetes.Diabetes can cause damage to the retina in the eye, which in worst case scenario can lead to blindness. In another arm of the project, all ophthalmology clinics in the 20 districts hospitals will integrate a screening program for diabetic retinopathy. Screening programmes will result in early detection of eye complications and provide proper management and care to the people affected by a diabetes eye disease.Advanced training of various health care professionals can unfortunately not be done in Bhutan, which is why it will be conducted in collaboration with the Bangladesh Institute of Research and Rehabilitation in Diabetes (BIRDEM). BIRDEM is a WHO collaborating centre for prevention and control of diabetes and has the expertise to provide training of the health care professionals. Training will be conducted both within- and outside of Bhutan.IEC materials and diagnosis flow charts will be developed for the health workers. This material shall help health workers to design banners and writing of leaflets for awareness and advocacy campaigns. The campaigns will focus on diabetes and its risk factors and is expected to reach out to the general population.Finally, a school health program will be undertaken. In order to empower school teachers in screening the children for risk factors and provide guidance to support the children in leading healthy lifestyles they will receive appropriate training. Meetings and workshops will be conducted for the teachers in order to make them feel well equipped to implement the school program and provide information about prevention and control of diabetes to the students.
• 24 diabetes clinics strengthened• 171 community health workers trained• 271 nurses trained• 6,991 new diabetes cases registered and treated at the clinics• Screening for diabetes complications introduced