Mongolian national model of diabetes and DR care, Mongolia

Objectives

Strengthen the competency of health care professionals (HCPs) within diabetes management
Build the capacity of hospitals and tertiary facilities to screen, diagnose and treat diabetic retinopathy (DR)
Enhance collaboration between diabetes and ophthalmology clinics
Raise public awareness of and demand for diabetes and DR care

Approach

This project seeks to partner with the Ministry of Health (MOH) and the MDA to pilot a scalable and sustainable model of diabetes mellitus (DM) and DR management that can meet the growing needs identified in the recently-announced government NCD programme.

One focus of project activities will be enhancing collaboration between diabetes clinics and ophthalmology departments at secondary and tertiary level facilities. Improved communication along DR referral pathways will help to ensure that patients receive timely treatment and follow-up care without undue cost burdens.

Through hospital-based training and online training and support, Orbis will provide novel models for building the capacity of diabetes clinics at secondary and tertiary facilities to screen for DR and glaucoma, using a task-shifting approach. Training will also be provided to ophthalmologists to diagnose and provide timely laser treatment for DR. Orbis will provide necessary equipment at secondary diabetes hospitals and ophthalmology clinics (including fundus cameras) for screening DR. Tertiary hospitals will receive essential equipment to diagnose and treat DR, while leveraging the use of fundus cameras to screen for glaucoma at minimal additional cost.

Furthermore, this project seeks to support training in newly revised guidelines that can be adopted nationally to guide DM and DR care and to advocate the government for scale-up across the country. Importantly, the project also will improve patients’ awareness of the threats of DM and DR and the need for early treatment and care, even before symptoms appear, to prevent medical complications and vision loss. This will help to drive demand for care and improve long-term adherence among those already in treatment.

Expected results

90 doctors and 12 nurses trained in diabetes eye care
80 community health care workers trained in DM care and prevention
Six clinics capacitated and equipped for DM management, incl. DR diagnosis and treatment
22,000 DM patients screened for DR and glaucoma; 1,320 persons with DR receive treatment (laser or injection)
18 screening camps organised, and 1,800 people screened for DM
and more