Community-led program to prevent diabetes targeting the impoverished indigenous people specialising on diabetic foot-care, West Tripura, India

Objectives

To raise awareness and screen indigenous groups for diabetes and foot problems
To train doctors in diabetes foot care
To train community health workers on diabetes and foot care to provide basic care at the doorsteps
To establish diabetes clinics at the community level

Approach

Through the project local doctors and surgeons will be trained in diabetes and foot care, incl. ulcer management through a three-day course conducted by state level experts. Hereafter community health workers will be trained to form field teams which will provide basic diabetes care and prevention at the village level. The teams will consist of both ASAH workers and traditional healers who will participate in a five-day training program on diabetes prevention, diagnostics and care. Later on, the teams will also be trained in diabetes foot screening and management and they will be provided with diabetes foot care kits.

Screening and awareness camps will be organised across the villages where at-risk persons will be screened and health education will be provided to all.

Diabetes clinics will be established at the village level to provide basic diabetes services such as diagnostics (OGTT), counselling and foot screening. Clinics will be established in existing public health care facilities under Department of Health and will be managed by the trained HCPs. The clinics will receive diabetes patients identified through camps and provide care for them. Electronic patient registers will be introduced at clinics.

A referral system will be established between camps, diabetes clinics and referral hospitals. The patients will be followed-up through a SMS system to ensure that proper care is provided.

Results at completion

4 diabetes clinics established
20 doctors incl. surgeons trained on foot care
50 CHW trained in diabetes and foot care
20,376 at-risk persons screened for diabetes
10,595 diabetes patients screened for diabetes foot complications
360 awareness and screening camps conducted
59,831 people sensitised on diabetes and foot care