Increasing public sector capacity for diabetes management in Laos

Objectives

The World Health Organization (WHO) Diabetes 2016 Country Profile for Lao PDR reports a diabetes prevalence of 5.6% in the general adult population. Approximately 2% of the Lao population dies from diabetes each year, with a 3.6% prevalence rate among adults 20-79 years. Hypertension among adults ages 15-64 is estimated at 18.7%.

The Laotian government is beginning to pay more attention to diabetes as an important health concern in the country. In 2014, the country engaged in World Diabetes Day, aiming to educate its populace about the risks of diabetes and how best to prevent the disease. This was part of a larger World Diabetes Foundation-funded project that also aimed to strengthen the diabetes health care system in Lao PDR. The project also aimed to create and support four diabetes clinics in the country.

Objectives
The project seeks to improve and standardise health care services towards diabetes, gestational diabetes and hypertension in Laos.

Approach

This project aims to strengthen Laos’ ability to respond to the growing threat diabetes poses to the health and development of the country by establishing national policies on the treatment of type 2 diabetes, hypertension, and gestational diabetes in Lao PDR. Currently, no such policies exist at the national level, and most health care providers lack the necessary training and skills to provide proper treatment to individuals suffering from these afflictions.

PSI and the MoH have developed a three-year plan for the creation and implementation of an initial national response to diabetes and its common co-morbidities. PSI will work with multiple stakeholders, including the MoH and the WHO, to develop national guidelines for each target health area and create training modules for health care providers based upon the guidelines. In addition, PSI and the DHC will educate health care providers at hospitals in Vientiane Capital, Champasak, Luang Prabang and Savannakhet on proper diagnosis and treatment of type 2 diabetes, hypertension, and gestational diabetes. These hospitals will become centers of excellence on diabetes, hypertension, and/or gestational diabetes management. The project thus aims at establishing a sustainable framework for diabetes care by providing both national guidelines and training modules that will last long beyond the project’s completion.

Results at completion

Five tertiary level hospitals in four provinces strengthened towards provision of standardised care and management of type 2 diabetes, gestational diabetes and hypertension.
39 healthcare providers (19 doctors and 20 nurses) trained in type 2 diabetes management with cross-training in hypertension and gestational diabetes
11 providers trained in hypertension management with cross-training in type 2 diabetes and gestational diabetes
46 providers (24 obstetricians and 22 midwives) trained in gestational diabetes management
At least 130 HCPs trained through subsequent cascade and in-service trainings
Diabetes patients at the targeted hospitals (currently more than 12,000) are treated and monitored as per roll-out of improved records and clinical indicators