The prevalence of blindness in Indonesia is one of the highest amongst the countries in South East Asia. One of the leading causes of blindness among the working-age population is Diabetic Retinopathy (DR). Less than one third of primary health care clinics have adequate eye examination equipment, and DR blindness prevention is not a government priority.As the number of people with poor controlled diabetes in Indonesia continues to increase, more people will be at risk of developing blindness and vision loss. Early detection and treatment of DR is thus of utmost importance to reverse this trend.During the WDF funded project (WDF08-335), Hellen Keller International (HKI) Indonesia established the first DR screening and treatment programme for people with diabetes. Although successful, this initiative needs to be scaled up in order to reach a larger part of the population. The aim is to prevent vision loss due to diabetic retinopathy among the vulnerable population in Indonesia.
Based on HKI-Indonesia previous experience, health service delivery gaps needs to be addressed and awareness of DR increased. HKI Indonesia will therefore engage the Ministry of Health (MoH) and the local diabetes associations to strengthen the diagnosis and treatment capacity of DR within the health system.This project has five main components:1. To develop a strategy to integrate DR treatment into the national standard of care:HKI-Indonesia will provide technical assistance for key stakeholders to develop a framework for DR screening and treatment and it will advocate for the inclusion of this framework into national guidelines. HKI will also advocate for the inclusion of a DR education module in the training curriculum of the community nurses programme for diabetes. Furthermore, HKI will work with local governments to establish a task force that will develop a detailed action plan to reduce barriers to the provision of DR services.2. To improve training for DR laser surgery across all teaching institutions in Indonesia:A week-long training-of-trainers workshop will be organized in collaboration with the Indonesian Association of Ophthalmologists. The physicians will receive training on the latest techniques for DR laser treatment and will subsequently transfer their knowledge for at least five peers. Questionnaires will be answered by participants during training sessions to assess the level of knowledge obtained and the effectiveness of the workshops.HKI-Indonesia will also advocate for laser surgery to be included as a part of the Ophthalmology Residency Programme curriculum.3. To develop a patient management system for people with diabetes:A key component of this process is the development of an integrated information system - linking screening sites to treatment centres - to establish an effective patient management and follow up system.4. Establishment of five diabetes care clinics:In collaboration with the Department of Health, at least five diabetes care centres will be established. Each of these centres will be linked to at least five primary health centres that provide education and referrals for people with diabetes. 5. To provide training to increase awareness about DR:Throughout the project, HKI-Indonesia will work with local departments for improving awareness of health providers about DR screening procedures and management of patients with diabetes at the primary and secondary levels. One half-day workshop will be organized each year for the newly recruited general practitioners at the diabetic service centres. A package with educational and communication materials will be distributed to the participants.
• More than 100,000 people received counselling on DR• 241 DR screening events conducted• More than 10,000 diabetes patients screened for DR• 4,866 patients with DR referred for treatment• 1,096 patients undergone advanced DR treatment• More than 120 residents trained and certified in laser treatment• 226 GPs and 154 nurses trained in diabetes, DR referral and sensitisation