The project will seek to improve access to quality diabetes and NCD care at the primary care level, strengthen capacity of HCPs, improve patient referral pathways, empower patients and implement evidence-based policies in Kyrgyzstan and Uzbekistan.
The project will leverage the work that the World Health Organization and WDF have supported in the region in previous years by consolidating the efforts and creating strong partnerships. The WHO PEN model and the WHO HEARTS technical package will be applied. The project activities are channelled through three tracks:1. Health system strengthening Improving clinical practice and quality of care through clinical audits, training, and supportive supervision at the primary level:Capacity building of 12 ‘local care teams’ (incl. a nurse, a family doctor, a community pharmacist, a specialist, a technician and a patient representative) in clinical protocols for integrated management of NCDs with a focus on diabetes, CVDs and hypertension and team-based care. Piloting innovative tools for clinical supervision, measuring and monitoring the quality of care through a digital platform and decision support tools in selected regions. Prevention of complications through strengthened referral pathways, follow up and coordination at the national level for each country. Gaps to be mitigated through capacity building, procurement, and deployment of equipment with a particular focus on diabetic retinopathy.Enhancing the role of nurses in NCD care through a review of the role and practice of nurses and the development of a new set of guidelines to be rolled out in both countries.2. Patient empowerment and involvement:Capacity building of nurses and other HCPs to provide patient education, drawing on WHO materials and evidence-based approaches and leveraging ongoing cross-country exchanges. Strengthening patient associations to provide patient support and engage in policy, care design and patient schools, leveraging previous WDF-supported projects and partners in both countries.3. Advocacy and policy strengthening:Development of a road map for prevention of complications in people with diabetes, with focus on CVDs and diabetic retinopathy.Establishment of a Project Steering Committee led by the Ministry of Health to oversee the project and to ensure national level ownership and commitment. Corresponding steering groups to be formed in selected regions. Documentation of project achievements and learnings to inform policies and guidelines through baseline study, evaluation and implementation research. Patient experience and overall improvements in health outcomes to be included. Policy guidance and facilitation of knowledge and best-practices exchanged through policy dialogue with relevant stakeholders and authorities.
All HCPs in two target areas in Kyrgyzstan and Uzbekistan trained, incl. 343 doctors and 877 nurses.745 nurses trained in diabetes foot care and prevention.Patient pathways for diabetes care and complication prevention developed.1147 people with diabetes undergone regular foot examinations at strengthened clinics.2162 people with diabetes screened for diabetic retinopathy.Quality improvement skills such as clinical audits, indicator measurement and supportive supervision institutionalised in target areas. Two national-level situation analyses conducted on the prevention of complications.New guidelines developed on the role of nurses in NCD care.In Uzbekistan in the period from 2022-2024, the incidence of DM increased with 8.9% in target districts compared with 1.1% in control districts.https://www.who.int/europe/event/tallinn-charter-15th-anniversary-health-systems-conference--trust-and-transformation---resilient-and-sustainable-health-systems-for-the-future#:~:text=On%2012%E2%80%9313%20December%202023,commemorate%2015%20years%20of%20the