BackgroundRivers State is one of the 36 states of Nigeria, located in the oil-rich conflict region of the country known as the Niger Delta. In spite of its crude oil producing status, majority of its residents live either in underdeveloped rural communities or urban slums without basic amenities of light, water or access to basic health facilities. Gestational Diabetes (GDM or diabetes in pregnancy) levels as high as 15.2% has been found in Rivers State. Pregnancy complicated by GDM is a high risk pregnancy with a tenfold increased perinatal mortality rate, greater risk of adverse pregnancy outcomes, a higher risk of developing type 2 diabetes later in life & babies born also have a higher risk of developing type 2 diabetes in their teens or early adulthood. Currently, management of GDM in Rivers State is very poor with poor feto-maternal outcomes. ObjectivesThe objective of the project is to pilot a gestational diabetes care project targeting poor women in Rivers State, Nigeria.
In order to coordinate the project and ensure broad ownership the project will establish a multi stakeholder committee consisting of 25 representatives of government authorities, medical professionals, civil society, GDM ambassadors, the project implementation team and facilitated by the Federal Ministry of Health. To improve the capacity of personnel to care for pregnant women with GDM new guidelines and protocols will be developed in accordance with international standards and health care personnel at all levels of care (primary, secondary and tertiary) will be trained in screening, detecting and care for GDM patients. In order to improve the quality of care universal screening for GDM will be rolled out and clinics will be improved through provision of equipment . All detected cases of GDM will be referred to treatment and postpartum follow up. To follow up and document results extensive baseline and endline studies will be conducted and results will be communicated through peer reviewed articles and broadcast media.
30 health care units across Rivers State strengthened to conduct GDM screening and refer confirmed cases to treatment360 HCPs (primary and private clinics), 78 HCPs (secondary hospitals) and 162 HCPs (including obstetricians and gynaecologists at tertiary facilities) trained in GDM screening and management22,202 pregnant women screened for GDM and 1310 diagnosed with GDM and referred for followed up and treatmentEstimated 2,000,000 people reached through extensive awareness raising campaigns incl. 790 media broadcasts, annual stakeholder fora, community mobilisation campaigns and interpersonal communication