Gestational diabetes in central Uganda

Objectives

While diabetes is on the rise globally, the rate of growth is greatest among women. Diabetes in pregnancy needs urgent global attention, due to the short-term negative consequences on maternal and child health as well as the harmful long-term effects on both women and future generations.

Increased caesarean section rates because of macrosomic infants, obstructed labour and vaginal trauma are especially prevalent and may have serious consequences for the women and the infants - particularly in a low-income country such as Uganda.



Objectives

The project aims to promote awareness of GDM and its consequences amongst 10,000 women of reproductive age, and will also include women's champions and male role models to increase awareness and dialogue on GDM.

Finally the pilot project will document the experiences of integration of GDM services in reproductive health care services in a rural and urban Ugandan context.

Approach

The project activities will be carried out partly in the rural district of Luwero, Northwestern Uganda, and an urban setting in Kampala and include:

Development and dissemination of information, education and communication materials, other health education materials, training manuals and clinical guidelines.

Sensitisation and training of community health workers, pregnant women in reproductive age groups, women’s champions and male role models to raise awareness on GDM.

Given the fact that men still dominate the decision making arena in most communities, the project partners believe that change for women is easier achieved when involving men. Men will therefore involved as Male Role Models (MRM). During bi-annual meetings, male role models will share and report on how and what issues they have discussed with men in their respective sub counties in regards to antenatal care and GDM. The awareness-raising on GDM among men will be carried out through informal and formal meetings and get togethers on the football field, at other community meetings etc.

The project will provide training in 3-day sessions of antenatal care providers; midwives, nurses and clinical officers, from Luwero district and Mengo Hospital in GDM screening and management.

Services provided to the women will be: comprehensive care, incl. dietary and behavioural counselling, health education, one-step approach screening for GDM, referral and treatment and postpartum screening (6-8 weeks) and follow-up services to those diagnosed with GDM.

To advocate for routine GDM screening and increased funding, various local and national awareness and advocacy meetings will be organised. A workshop will be held to share experiences and outcomes of a feasibility study of integration of GDM in antenatal care settings.

Finally, being a pilot project, it will document experiences of integration of GDM services in reproductive health care services in a rural and urban Ugandan context.

Results at completion

23,953 women and 6,195 men sensitised/educated about GDM
20 awareness-raising meetings targeting male role models and 24 targeting leaders held
26 radio shows broadcast
GDM screening guidelines and referral mechanism developed and implemented
4 doctors and 92 ANC midwives trained on GDM
16 clinical officers, 20 women champions, 20 women pressure group members, 50 male role models and 75 village health team members educated on GDM
342 screening camps conducted; 11,069 pregnant women screened for GDM (overall prevalence of close to 10%)
Report with clear recommendations on the feasibility of implementing GDM screening and follow up completed