Nine in ten deaths in Georgia are estimated to be caused by NCDs which makes NCDs the main cause of mortality in the country. According to the 2013 Diabetes Atlas, 6th edition the estimated diabetes prevalence is 3% and prevalence of IGT is around 11%. However, it is likely that the situation is severely underreported.Set against a context of conflict and wide-spread poverty, migration and lifestyle changes, the health status of the Georgian population is among the worst in Europe. Challenges and interrelation of communicable and non-communicable diseases create a double burden on the health system which is already limited in its capacity to provide adequate health care.At the moment, diagnosis of diabetes is often made at an advanced stage of the disease which leaves a heavy economic burden on families as well as the health care system. Access to affordable care is particularly fragile in rural areas; hence the disease affects poor people disproportionately.Gardabani District is agricultural and one of the poorest districts of Georgia with 60% of households below the national poverty line. Primary prevention is almost unspoken of and diagnostic options are scarcely available among the intended target groups.Improved diabetes prevention, detection and care in Gardabani District in Kvemo Kartli Region, Georgia
Georgian Red Cross Society (GRCS) volunteers will be trained in primary prevention and detection of diabetes. This will be the basis for awareness raising and behaviour change promotion interventions to the general public and to people at high-risk of diabetes. The trained volunteers and master instructors are instrumental for the success of the project as they will reach the most remote corners of the country.Awareness raising events and youth meetings will also be organised. Every half year volunteers will organise a bigger community awareness raising event as sport-events, campaigns, competitions etc. as well as educational sessions will be conducted for youth.The volunteers play a crucial role in mobilising the communities to attend screening camps. The GRCS volunteers who are part of the communities will organise the awareness raising sessions and invite target groups directly by door-to-door visits and/or through their social networks to encourage participation. Also doctors and nurses will recommend people at-risk to contact the GRCS volunteers.Training manuals on the prevention of diabetes will be developed for master instructors and for volunteers.To reach an even wider audience, health promotion and diabetes prevention will be addressed in radio and TV-spots. Famous athletes and esteemed local celebrities will be asked to be ambassadors for the project to promote key messages of healthy and active lifestyle.Medical doctors will be trained in prevention of diabetes complications and referral mechanism. The training sessions will focus on enhancing knowledge, improving clinical skills and changing attitudes towards diabetes with the objective of providing better diabetes care service delivery.Mobile units will be established with the aim of reaching areas with no medical facilities. The mobile unit will bring diabetes diagnostic, primary prevention and secondary diabetes prevention to the inhabitants of the 21 villages in Gardabani district who have no health facilities and therefore very limited access to care.The mobile team will provide diabetes screening, regular blood testing and blood pressure control as well as educate patients with diabetes and promote self-care, healthy lifestyle and prevention of complications.Self-support groups of patients with diabetes and peer-support and education will be established in the communities. Among the activities are the establishment of one support group per project site; link of GRCS volunteers to each group to facilitate meetings/activities; establishment of “Walk and Talk” clubs and healthy cooking clubs.
• 23 clinics strengthened with diabetes care• 73 GPs and 110 nurses trained• 216 volunteers from 40 villages trained• 62,000 people reached by awareness events• 13,000 people at risk screened• 1,468 people diagnosed, treated and educated in self-management• 1.468 educated about diabetes• 45 self-support groups established• 1 mobile unit established• 1.557 awareness events• 92 patients screened for diabetic foot• 48 patients diagnosed with diabetic foot and received treatment