Diabetes education, prevention and management in Delmas 32, Haiti

Objectives

The urban district of Port au Prince was among the most severely affected by the 2010 earthquake and is hence one of the poorest areas of Haiti. Haiti is among the poorest countries in the Western Pacific with very limited resources to handle the diabetes epidemic.

Community Healthcare Workers within Port au Prince do have little access to diabetes training, due a.o. to the distance of the nearest diabetes association. With scarce resources, minor training and significant numbers of diabetes patients and at risk patients, there is a high need of support.

Objectives
The project consists of two specific objectives, namely to increase diabetes awareness through community sensitization campaigns, and empower individuals to engage in diabetes self-care management. By completing these objectives, diabetes care within Port au Price would be dramatically increased.

Approach

To launch the project a KAP survey will be implemented. The survey will target approximately 400 households which in total will constitute of 2,000 people. The survey will help establish baseline levels of knowledge and behaviour, while helping to determine communication messages, and how these messages must be shaped.

30 community health workers and 12 matrons will be selected by the project and receive diabetes training. The training will be tailored to reflect the findings of the KAP survey. Furthermore will the matrons be trained to recognize symptoms of gestational diabetes in pregnant women and refer them to a clinic for treatment.

The project will deliver an ongoing sensitization campaign where 14 CHWs will go from door-to-door and deliver information about diabetes. The estimated effect is a total reach of 40,000 people over the projects duration of two years.

Training of 20 nurses and 10 doctors will be conducted to increase their knowledge on prevention, treatment and care of diabetes. The training will take place during the first year while refresher training will be done during the second year of the project.

J/P HRO will launch a Diabetes Clinic with two sessions per week. During the two years, a total of 9,200 consultations will be reached. The clinical sessions will continue beyond the two years of the project.

J/P HRO runs 14 mothers clubs, where mothers and pregnant women receives guidance. The trained CHWs will sensitise these women about GDM symptoms and opportunities for prevention. In addition will they receive screening for GDM where those who are found to have GDM will be referred to the established clinic for treatment and will be followed up.

One specialist clinic will occur each month, focussing on providing high-quality eye and foot care, through deployment of the FHADIMAC mobile unit already operating under project WDF10-526. A total of 22 specialist clinics will be offered over the course of two years, which is estimated to include approximately 1,000 patient consultations.

Results at completion

48,539 people reached with awareness raising activities, leaving diabetes patients in a much stronger position to manage their diabetes
858 patients reached through 22 specialist clinics conducted by FHADIMAC, for eye and foot care
4,164 screenings completed for 694 pregnant women visiting the pre-natal clinic
3 mass awareness campaigns conducted during world diabetes day commemoration reaching 5,300 people
One Steering Group established that promoted local coordination to tackle diabetes
Community engagement to tackle diabetes improved
6 culturally appropriate diabetes materials developed and distributed; 32 HCP trained
One Electronical Medical Record (Isante) installed and utilized, and staff trained on its use