The Dominican Republic is a country where more than 50% of all deaths are due to NCD’s which have led to an increased focus on NCD during the last decade.Among the NCD’s diabetes has a prevalence of 10.6% which is more than the global average on 8.3%. The number of people affected by diabetes will grow from 245,000 in year 2000 to 594,000 in 2030 which calls for immediate action and awareness.The health system in the Dominican Republic is characterized by human resources which are not adequately distributed, neither geographically or in terms of competences. Accordingly training of health care professionals in hospitals and at community level is needed.ObjectivesThe goals for this project is to advance the National Program for Control of Non-Communicable Disease by increased access to care in rural communities and increase the awareness and competences in diabetes Care among the health care professionals and raise awareness in the general population.This project is the first of its kind with regard to diabetes and non-communicable diseases (NCDs) in the Dominican Republic. It calls attention to the importance of preventing, treating, and managing NCDs and advocates for increased focus and funding for this rising population and increased concern at the Ministry of Health level. It also increases the visibility of the problem of NCDs in the general population, through carrying out educational campaigns, awareness events and activities, and the community-level prevention work of community health workers.
The project contents a sequence of different activities:Provide primary care physicians and health care professionals with training using “The Basic Course on Integrated Management of the Diabetic Patient”.Diabetes screening days at 12 hospitals and several clinics at the World Diabetes Day where different materials, waæls, and education in exercise will be carried out.Public announcements and promotion for events, diabetes services, and screening days through already established structures within each community.The Provincial Clinical Supervisor with support from Health Horizons International (HHI) will conduct monitoring and supportive supervision of the primary care physicians and doctors at the 12 hospitals and health centres providing diabetes services.Training and supporting diabetes medical supply chain management for national and provincial level MoH staff led by Population Services International (PSI). The aim of this is building capacity in supply chain logistics.Develop and implement a two-way referral system between Community Health workers and hospitals and health centres for diagnosed diabetes patients. This will ensure that patients after referral from hospital or health centre will be supported by a Community Health Worker (CHW) to attend to appointments, adhere to medication regiments and so forth.The MoH and HHI will develop Diabetes Modules and a training Guide to complement the existing national training curriculum.A two-day training of Trainers of Trainers (ToT) for provincial MoH staff and CHW supervisors on the CHW Training Modules and Diabetes Modules.Community level diabetes education by CHW through organized education session and home visits.Regional Meeting regarding diabetes treatment and prevention issues for CHW
The project strengthened the health system capacity in several important ways. The development and implementation of tools for assessing chronic disease risk factors at the community level, utilising community health workers to identify and link at-risk patients to primary care centers and training zone coordinators to provide stronger supervision of services will have lasting benefits in providing and assuring quality of care. Highlights of the project's achievements include: - 12 primary care centers strengthened in establishing the systems, practices and tools necessary to provide comprehensive care to chronic disease patients. - 54 doctors trained in comprehensive diabetes management, with specialised training in the prevention, care and follow-up of diabetic foot. - 60 community health workers trained in the detection and prevention of diabetes risk factors at the community level. - 24 nurses trained in the management of healthy lifestyle and support groups for chronic disease patients.- 6,000 at-risk people screened for diabetes and hypertension - 4,000 diabetes patients provided care