Capacity development for combatting GDM, Bangladesh

Objectives

Considerable progress has been made in communicable disease control in Bangladesh, but non-communicable diseases (NCD) continue to show a rising trend. The International Diabetes Federation (IDF) in 2012 estimated the diabetes prevalence in Bangladesh to be 6.14 % corresponding to 8.99 million of the adult population. Estimates from the World Health Organisation (WHO) in 2008 show that the average body mass index (BMI) for women in Bangladesh increased from approximately 18 to 20 between 1980 and 2008 while the average BMI for men has remained unchanged. In the same period of time the average mean fasting blood glucose has increased from an average of 4.8 mmols for women and 5.2 mmols for men to an average 5.4 mmols for both men and women.

A small study in Bangladesh has shown that approximately 10 % of pregnant women suffer from Gestational Diabetes Mellitus (GDM). There is very little awareness of this vast problem and there are no existing programs for prevention and care of women with GDM.

The goal of the project is to develop capacity in terms of human resources, well formulated policies, standardized protocols, culturally sensitive BCC tools, and organized awareness/advocacy campaigns which ultimately will equip Government Organisations, NGOs and private sectors for better prevention and management of GDM.

Approach

The project will be implemented through a step-wise approach. The first step is to form an expert panel and hold a workshop to do a review of available guidelines related to GDM and finally develop a consensus document on screening, diagnosis, management and follow-up of GDM.

Step two is to develop training materials for health care professionals at different levels. Training programs will be conducted for health care professionals at all levels, but for specialist there will be special training to secure implementation of the new consensus documents. Training will be done in both vertically, consisting of all health care professionals from one district, as well as horizontal clusters, consisting e.g. of all nurses from four of the 64 targeted districts. Each trainee will be assessed for their baseline knowledge and skills through a simple survey and again at the end of the project as part of the training program.

The third step is to do promotional and advocacy campaigns by conducting activities to mobilize the community, policy makers, pregnant women and their families for health education, counselling and prevention. Posters, leaflets, booklets, flip charts, bill boards, and audio-visual programs for mass media including websites will be developed as part of the campaign.

Finally a workshop will be developed to design national policies, strategies and work plan on GDM. The workshop will be based on experience and feedback generated through the project and participants will be specialists, health professionals and other stakeholders.

Results at completion

- Consensus Guideline for the prevention, detection, management and follow up of GDM incl. training modules developed
- A total number of 3,546 HCP trained (doctors 1,042, nurses 99, nutritionists 147, paramedics, health educators and other professionals 1,360)
- A total number of 56 advocacy meetings with opinion leaders organized
- A total number of 21 awareness symposia conducted
- A total number of 46 awareness activities conducted