In Georgia poverty is the single most important contributor to ill health in the population. Although many essential components of diabetes care exist there are no preventive services, and particularly poor and rural areas experience significant systematic barriers for delivering affordable and accessible diabetes care. Better coordination is required between different levels of care, medication distribution and insurance plans to address prevention and care of diabetes and curb the rising expenses due to poor care.. There is a critical need for essential diabetes information, health education and system navigation for people with diabetes. Public and key stakeholders need to be aware of the need for prevention, providing basic health care and social issues facing people living with diabetes.The goal of this project is to improve diabetes prevention and care in targeted areas and among targeted populations.
Nine diabetes project centres (DPC) will be organised around health care clinic setting or other community activities. The DPCs will be integrated into the existing local health care infrastructure at the projects sites. Each DPC will have at least one dedicated coordinator, physician, nurse, social worker and diabetes liaison person. DPC coordinators will be in charge of the day to day management in each centre. The DPCs will serve as informational hubs coordinating all needed information for patients, their family members and caregivers in one place. Services offered include information about diabetes, its primary prevention, informational materials for people living with diabetes and their family members, clarification on patient coverage, process to obtain medications etc. After project completion the DPCs will continue their work with financial support from key supporters, public funding, health insurance companies etc.Education material based on the best examples will be prepared. A patient resource website will also be developed. The website will provide diabetes care/prevention navigation tools which contain information about health care facilities and providers, patient education materials and training, patient associations and support groups etc.As part of the project 18 peer educators and 40 peer advisors will be trained. The peer educators will provide training for future peer advisors to educate people living with diabetes and their family members on how to self-manage their disease, early detection and prevention of complications. After training the peer advisors will lead groups of 20 people and each group will have 10 sessions totally.Educational programs for primary care physicians in the targeted areas will be set up. 20 general practitioners will be trained and work as project trainers. The projects trainers will train another 140 general practitioners in the targeted areas. For the general practitioners web-based/printed resources will be created on evidence-based clinical guidelines. The general practitioners’ health clinics will be provided with basic screening equipment and supplies. A diabetes care quality metrics tool will be developed by a multidisciplinary team to measure quality of care and identify future needs.The project seeks to strengthen organizational capacity of diabetes associations/patient support groups through leadership, management, advocacy and fundraising training. After training each diabetes centre will, in collaboration with patient associations organize and conduct fundraising activities, plan and implement advocacy campaigns and improve organizational resources for people living with diabetes.Finally, the project seeks to improve public and key stakeholder awareness about diabetes prevention and issues related to health care, social resources and rights of people living with diabetes through annual screening events in both the first and second year of the project to screen high risk population. The screening capacity will ensure at least 35 % of the local population is screened. These events will be critical to improve diabetes surveillance and identification of the true prevalence in the population.A media campaign in each target area about primary prevention and healthy lifestyle improvement for the general public will be planned and implemented by project beneficiaries. A round table conference with key stakeholders at regional and national level about future strategies will be held. The expected outcome from the round table discussions is a strategy plan.The project has a special poverty focus and plans to target the most vulnerable groups of the population by giving them access to health care educational resources to protect them from further risk of impoverishment by the costs of treatment of diabetes complications.
• 6196 persons screened for diabetes• 6941 people living with diabetes and their families trained through educational programs• 10 diabetes patient project centres organised• Training program, quality metrics and essential resources for primary care providers developed• Expanded and strengthened organizational capacity for people with diabetes through patient support groups• Campaigns about diabetes prevention and care performed