Mainstreaming quality Diabetes care within India’s public health system

Objectives

The project seeks to mainstream national policies for GDM universal screening and management of post-partum follow-up in two Indian states. The project also aims to implement GDM policies in Madhya Pradesh, population 72,6 million, and roll out a pilot project in Maharashtra, population 112,4 million.

Approach

The project activities will be channelled through the following three tracks:

Health system strengthening:
Developing a state-level road map and operational plan (covering budgeting, capacity building plans, logistics and procurement) for roll out and scale up of GDM services based on consultations and a landscape and gap analysis of current GDM services in each state.

Ensuring district-level planning, supervision and monitoring of the GDM road map roll out by building local capacity in programme planning, budgeting, resource mobilisation, training facilitation and review of GDM services.

Conducting rapid health facility assessments jointly with state and district governments to facilitate the operationalisation of GDM service delivery aligned with GDM road maps.

Leveraging digital solutions (decision support tool for HCPs and mentoring and patient support tools) to improve treatment outcomes and patient experience.

Capacity building of HCPs in GDM diagnosis and management and post-partum follow up through capacity building plans co-developed with the state governments.

Training will use the ToT approach leveraging trainers from previous projects in MP.

Community engagement:
Piloting of community empowerment processes for GDM care (one district in each state) incl. training frontline HCPs (ToT) in counselling and self-care, hosting monthly meetings for women with GDM and family members.

Advocacy and knowledge generation:
Establishing steering committee in each state chaired by health authorities and incl. representatives from health providers, CSOs, women’s groups, professional bodies, and academia.

Improving government monitoring tools through biannual road map implementation reviews using digital dashboards and integrating GDM data elements into existing monitoring tools.

Providing technical support to district and state-level health authorities to ensure implementation of GDM services according to the roadmap.

Facilitating knowledge and exchange of cross-state learnings, and documenting best practices and learnings, to build outcome-based evidence and advocate for national-level scale up. Coordination and collaboration with FOGSI and WHO will be sought.

If requested, Jhpiego will provide technical assistance to other states to initiate the development of GDM road maps.

Substantial M&E component to be rolled out, incl. a real-time digital data collection platform with key health outcome data. Government HMIS will further be strengthened.

Expected results

Roadmap for GDM scale-up updated in Madhya Pradesh and developed for Maharashtra
1,010 facilities assessed on GDM services, with direct implementation support in selected districts, regular facility assessments, and technical assistance provided at the district level
Improved access to GDM screening and care in 1,010 public health facilities
24 HCPs trained as master trainers (ToT) in GDM national guidelines in Maharashtra
Master trainers (both new and previously trained) cascade training to 154 doctors, 1,843 nurses and 7,142 other HCPs
More than 145,000 pregnant women screened for GDM through OGTT
Post-partum follow-up and treatment of 3,087 confirmed cases
Dashboard for informed, data-driven decision making developed and operationalised
Digital decision support tool and digital support tool for self-care developed and rolled out
Two experience and learnings workshops on GDM conducted at the national and state level