Integrated diabetic Retinopathy care in Nepal

Objectives

• Integrate diabetic retinopathy care into routine health services for people with diabetes
• Train health care providers to integrate screening, referral and treatment of diabetic retinopathy into routine diabetes care
• Develop national guidelines for the management of diabetic retinopathy within the public health system of Nepal

Approach

A national guideline for screening and management of diabetic retinopathy in Nepal will be developed through workshops and roundtable meetings with the Ministry of Health. The guideline will form the basis for the implementation of the project.

Health care providers such as diabetologists, ophthalmic nurses and paramedics working in the public hospitals will be trained in diabetic retinopathy screening and basic care. Eye doctors (ophthalmologists) will be trained in specialised treatment, including screening with fundus camera and laser treatment. Throughout the duration of the project extensive support and supervision will be provided.

After the training diabetes eye screening and care will be provided as an integrated part of routine diabetes care at selected public hospitals. To be able to deliver diabetes eye screening as part of the diabetes care package fundus cameras will be provided to the participating hospitals. Referral pathways from general hospitals to tertiary eye care hospitals will be established and a referral system will be installed by introducing referral cards. A SMS follow-up system will be developed and implemented.

Different sensitisation and advocacy activities will be done to promote awareness of diabetic retinopathy by distributing IEC materials, publishing radio slots and conducting activities on World Diabetes Day.

A comprehensive monitoring framework will be rolled out and KAP surveys at baseline and endline will be done.

Results at completion

7 public hospitals strengthened with diabetes eye care
65 HCPs trained in DR screening and fundus camera
8 ophthalmologists trained in advanced DR care
20,072 diabetes patients screened for DR
At least 2,286 people with DR referred
1,606 DR patients treated with laser
National guideline on DR in Nepal developed and endorsed by MoH
An estimated 1,5 million people reached through awareness campaign