In Indonesia, the diabetes prevalence is expected to increase by 154% between 2000 and 2030. With such a rapid expected increase in the number of people with diabetes it is vital that access to care is improved. Although a large number of Indonesian health care providers have been trained in diabetes care under the WDF funded project WDF06-173, access to diabetes care is still limited. Therefore, the Indonesian Diabetes Layman Association (PERSADIA) and the University of Indonesia are launching a model for diabetes management in primary health care settings in Indonesia. The objective of the project is to establish a sustainable model for diabetes care and prevention at primary care level in Indonesia.
The project is a continuation and expansion of the previous diabetes management programmes in Indonesia funded by WDF (WDF05-136 & WDF06-173). During this project, a model for diabetes management will be established and piloted in 3 different settings in Indonesia. The prevalence of diabetes varies quite a lot from urban to rural areas. However, especially in remote rural areas data is lacking. For that reason, the project will be initiated with a situation analysis on the burden of diabetes in one of the pilot settings - the remote island of Ternate. Through this activity those with diabetes and at high-risk of diabetes will be identified. A detailed protocol on diabetes management will be developed. The protocol will be based on current guidelines on diabetes management which were updated under the WDF funded project WDF06-173. Compared to the guidelines, the new protocol will be more focussed on practical diabetes management - how to set up the diabetes care centres, identify patients, carry out and administer activities etc. Through WDF06-173 a number of health care providers were trained in diabetes management. These health care providers will also be part of this current project as they will be trained in the clinical aspects of diabetes management, in providing psycho social support, methods of promoting patient empowerment, motivating change and how to establish diabetes management centres. The training of health care providers will take 3 days. Upon completion of the training, the health care providers will be working in teams to prepare and set up a diabetes centre in their local area. A total of 3 centres will be established in three different islands. The centres will be located within existing primary health facilities and the health care providers will receive the necessary equipment and education materials. Following establishment of the centres, identification and recruitment of patients will begin as will the provision of care. To ensure consistency of the programme follow-up visits and a yearly meeting will be conducted. Self-management skills have been identified as key in diabetes management. Therefore, education on self-management of diabetes will be given to patients through group-based training. Each centre will also carry out primary prevention of non-communicable diseases. These activities will target the general population and include measurement of blood glucose and blood pressure, health counselling and education on diet, physical activity and other related health topics. These primary prevention activities will be conducted once a month.
- Three diabetes clinics were established within existing primary health centers- 26 primary health care teams were trained on the protocol for diabetes management in primary health care setting. - 2,920 people participated in primary prevention program