Gestational diabetes can lead to malformations in the child, increased risk of mortality and increased risk of developing diabetes later in life for both the mother and child.The prevalence of gestational diabetes in Cameroon as well as the rest of sub-Saharan Africa is not known, but it is likely to be considerable due to high rates of obesity.Although access to health care is limited in Cameroon especially outside the main urban areas, the majority of women attend an antenatal clinic during their pregnancy. However, awareness of gestational diabetes is lacking among both the women as well as the health care workers.The project seeks to raise awareness, build capacity and promote large scale screening for gestational diabetes mellitus (GDM) within the public health care service in Cameroon.
The project is implemented in all 6 provinces of Cameroon. In each province, one hospital is selected based on the existence of a diabetes clinic. The diabetes clinic is necessary to support the antenatal clinic which will be the primary setting at the hospitals. The clinics were established under 2 previous WDF funded interventions in Cameroon: WDF02-016 and WDF05-117, CAMBOD.Initially, a rapid assessment of the health care provision in the provinces will be carried out.This will be followed by the training of 300-400 health care workers and 50 traditional birth attendants. The training will be centred on diagnosis, management and referral of GDM and pre-GDM according to their position and level in the health care system.In addition, local NGOs and community leaders, who will act as partners in the communities, will be capacitated to lead population based sensitisation campaigns targeting women in the communities.At the antenatal clinic at each of the target hospitals, all women attending the clinic will be screened for pre-GDM and GDM resulting in 10,000 women screened. Women diagnosed with pre-GDM or GDM will receive care and education in order to ensure proper management and follow-up of pre-GDM/GDM and to facilitate safe pregnancies and deliveries with healthy outcomes.It is expected that between 100-500 women will need treatment for pre-GDM and 200-700 women will need treatment for GDM. Existing screening and management guidelines will be adapted and used in conducting the screening and management of pre-GDM and GDM. Finally, an economic evaluation of the screening and management strategies will be carried out. The effectiveness, cost effectiveness and applicability will be analysed and the results will be disseminated to the policy makers with a view to include GDM in the existing National Diabetes Programme in Cameroon.
- Training of over 400 heath care personnel, 58 traditional birth attendants, 30 NGOs to strengthen the GDM programme nationwide- Over 21,000 women screened for gestational diabetes- 943 women treated