Training of trainers, five provinces, Peru

Objectives

The prevalence of diabetes has reached 5,6% in Peru, and it is estimated that as much as half the adult population is overweight. The prevalence is especially high in the capital of Lima and in five other main cities located in five different provinces. Up to 45% of the Peruvian population does not have proper access to the health care system, but in these particular five provinces health care coverage is exceptionally low.

Peru has had a national diabetes plan since 2008. However, this plan has witnessed very little progress due to a perpetual lack of resources in the public health budgets.

To date, diabetes education and awareness activities, as well as health promotion in general, have been very limited and confined to Lima. Consequently, there is a profound lack of knowledge about diabetes among health care providers, patients and the general population leading to high complication rates and premature death.

The aim of the project is to reduce diabetes-related complications and improve quality of life by improving the knowledge level among health care professionals, patients and the general population in five underserved provinces of Peru.

Approach

WDF has previously supported a regional project seeking to establish diabetic foot care at selected primary care units in five Latin American countries, including Peru (Eje Vascular Andino (EVA) or the Andian Vascular Axis WDF05-135). This current project is the first WDF-supported project focusing solely on Peru.

The project is implemented by the Peruvian Diabetes Association (ADIPER) in association with the Ministry of Health with co-funding from Roche Peru. It is aligned with the national diabetes strategy.

It seeks to improve the quality of life for people living with diabetes by improving the level of knowledge among health care workers, patients and the general population. The project aims at reaching many undiagnosed diabetes patients in remote villages with limited access to diabetes care facilities.

The project will establish a multidisciplinary team within ADIPER consisting of IDF-certified endocrinologists, nurses and nutritionists. This team will conduct training of diabetes educators, applying the latest ALAD (the Latin American Diabetes Association) guidelines.

The team will train approximately 900 primary physicians, nurses and nutritionists from five provinces to become diabetes educators. These particular provinces have been selected because of their high prevalence of diabetes, extreme poverty and very limited access to diabetes care and prevention.

The trained health care providers will represent the full range of social security hospitals and Ministry of Health hospitals in the five provinces. The diabetes educators are supposed to increase awareness and knowledge-levels of people living with diabetes as well as the general population. Furthermore, they are expected to conduct screening to detect new diabetes cases.

Roche Diabetes Care in Peru will provide support in terms of establishing an online diabetes patient registry and diabetes educator database. This will enable better monitoring and follow up, thus facilitating continuity of care.

The project model is envisioned to be replicated throughout the country upon project completion and evaluation.

Results at completion

• 1,074 health care providers trained as diabetes educators
• Patient registry established and educational activities took place for diabetes awareness