Belize diabetes self-management care and training

Objectives

To implement the first phase of a national diabetes/NCD response programme with focus on primary care and community level.

Approach

1. Capacity building based on provision of basic equipment to all existing public primary care facilities and MoH district offices; and on training of health educators, nutritionists, nurses and CHWs (incl. certification) to carry out community-level diabetes self-management education, following the adaptation of a diabetes specific curriculum developed by PAHO and following IDF and WHO-PEN model guidelines.

2. Rollout of community education programme for diabetes patients through health promotion activities, group sessions, text messages and distribution of education materials; patients to be recruited from primary care facilities as well as through CHW outreach

3. Establishing of referral system through CHW patient outreach informing about available primary care services (incl. foot care, eye care and medication) using a standardised MoH form; primary care services to counter–refer patients to CHWs for follow-up education etc.

4. Establishing of patient registry and M&E system based on extensive clinical indicators (incl. HbA1c) and standardised self-care questionnaires to assess and demonstrate impact; data collection to be based on standardised MoH forms and to be recorded in an EMR; data to be integrated with MoH health information system.

Results at completion

25 primary health care units (all existing primary clinics in Belize) and 8 MoH district offices in 6 districts provided capacity building.
8 health educators, 9 nurses and 1 nutritionist trained in community-based diabetes self-management
208 CHWs trained and certified in community-based diabetes self-management education
At least 447 patients receive diabetes self-management training and registered and monitored
1,500 family members sensitised on diabetes by the enrolled patients and community level activities
Approx. 20,000 people with diabetes (diagnosed and currently undiagnosed) to potentially benefit from this project in longer term (total Belize population is 387,000)