This project will reinforce the implementation of the WHO/PAHO HEARTS in the Americas initiative to which the MoH has committed.It builds upon structures and procedures successfully established under WDF16-1422 (the first step of WDFs support to a national diabetes/NCD response), which targeted three provinces. The current application targets 18 provinces/five regions (representing est. 7 million people out of a total country population of 11 million), expanding some initiatives while implementing the technical package from WHO/PAHO HEARTS to improve clinical preventive services in PHC.Main activities:• Roll out integrated diabetes services at each targeted facility through provision of equipment and comprehensive training/supervision from the regional and national level based on WHO HEARTS.• Development of a baseline of the health situation for NCDs focused on diabetes and hypertension and their risk factors by using the STEP tool.• Revision and development of national protocol, training, and IEC materials, including protocols for co-morbidities.• Develop a strategy to educate and sensitize the population and groups at high risk in the prevention of diabetes and hypertension• Establishment of supervision and monitoring system for NCDs• Strengthening of the active and routine surveillance system for TB/DM comorbidity
• Investigation of the NCD health situation at the national level focused on (diabetes and hypertension) and their risk factors conducted using the WHO/PAHO STEPS tool• 720 doctors, 540 nurses, and 540 health promotors trained in diabetes/hypertension care and prevention. • 150 primary level health facilities strengthened with comprehensive diabetes and hypertension care and able to provide quality care to est. 750,000 people• 150 peer self-support groups established, and 3,000 patients trained in diabetes self-management and healthy lifestyle• 18,000 people at risk for T2DM/hypertension identified and receive counselling• 15 diabetes walks to raise awareness among the population• 10 health fairs to raise awareness in the community about the prevention and timely detection of diabetes and hypertension• 50,0000 people reached at awareness raising activities related to DM, hypertension and NCD risk factors • 400 health facilities strengthened for active and routine surveillance of TB and DM comorbidity • 450 doctors, 450 nurses, and 450 promoters trained in active surveillance, prevention, and control of TB and DM