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NIROGI Lanka

National Initiative to Reinforce and Organize General diabetes care In Sri Lanka

OVERVIEW

The Government of Sri Lanka of including the Ministry of Health is committed towards a free health service with special emphasis placed on quality care. It has recognized the need for targeting chronic non-communicable diseases (NCD), in particular the rapidly increasing number of diabetics within the lower socio-economic strata.

NIROGI Lanka project is an initiative directed at the lay public at risk of developing diabetes (DM) and cardiovascular diseases (CVD), and persons already suffering from DM and its complications, living or working in the suburban and Metropolitan city of the district of Colombo or attending the state and private sector curative settings throughout Sri Lanka. This project was conducted by the Sri Lanka Medical Association (SLMA) in collaboration with the Ministry of Health. The project was funded by the World Diabetes Foundation and second health sector development project Ministry of health, with the aim of improving the quality of diabetes care and its delivery particularly in the lower socio-economic groups. Hence, this project fulfils the necessary criteria as a charitable project.

Fromm 2009-20015 , NIROGI Lanka project was funded by the World Diabetes Foundation (WDF), which is an independent and non-profit organization governed by the Danish Foundation Act. It has been established in 2002 with the vision to alleviate human suffering related to diabetes among those least able to withstand the burden of the disease. It has grown into a leading international funding agency supporting grassroots initiatives in the area of diabetes prevention and care to work in partnership, across sectorial boundaries and disciplines, at the global, regional, national and local levels, to ensure optimal health care delivery in low resource settings.

The main goal of NIROGI Lanka project was to improve the quality of diabetes care and to strengthen primary prevention of diabetes and cardiovascular disease risk in defined areas in Sri Lanka. To this end, the project aimed at improving the overall diabetes care through capacity building of medical and allied health professionals with special emphasis on self-care to improve diabetic foot care that would prevent limb loss; to reduce hospitalization for diabetes complications; to target at risk individuals in urban and suburban settings for screening; and to strengthen long-term follow up of diabetics and high-risk individuals including women with previous gestational diabetes. The project also aimed at establishing a low cost culturally appropriate health promotional model to empower people in suburban and highly urban Metropolitan areas towards healthy lifestyles by enhancing community participation through already existing networks of the formal sector (Ministry of Health, Ministry of Education, Provincial Directorate of Health Services of the Western Province, Banking sector) and also the informal sector (community organizations, bank loan schemes) to strengthen primary prevention of diabetes and CVD risk.

THE PROJECT AIMS

  • To improve the overall diabetic care through capacity building of allied health professionals with special emphasis on self-care including diabetic foot care that would prevent limb loss; reduce hospitalization for diabetes complications; and strengthen community based health promotion

  • To strengthen the long-term follow up of high risk individuals including women with previous gestational diabetes and those with diabetes in the urban and semi urban settings

  • To improve the quality of diabetic foot care in Sri Lanka

  • To improve the quality of maternal diabetic care in Sri Lanka

  • To encourage primary prevention of diabetes in conjunction with the Ministry of Health and Ministry of Education within the Colombo Municipal Council (CMC) and a selected suburban centre

PROJECT OBJECTIVES

  • To initiate a national programme for capacity building in diabetes care by establishing a pioneer cohort of ‘diabetes nurse educators’ in Sri Lanka

  • To improve the quality of diabetes care by establishing a health care model of tertiary-primary care partnership in Colombo by
    • Provision of quality diabetes care for residents living in the Colombo Municipal Council area through a partnership between the tertiary care and the primary care services.
    • Development of the infrastructure in the primary care health services of the Colombo Municipal Council for provision of such care.
    • Training of primary care medical practitioners
    • Strengthening of laboratory services for diagnosis and management of diabetes and cardiovascular risk factors at primary care

  • To Prevent Type 2 Diabetes by empowering the public through activities that encourage community and family participation in a defined area of Suburban area of Colombo
    • Capacity building of health workers and Health Promoters in identified settings to implement programmes to prevent Type 2 Diabetes.
    • Empower communities in different settings that encourages positive behaviour (e.g. schools, workplaces and community)
    • Identify those at risk and provide preventive care at grass root level

  • FOR ALL OF THE ABOVE
    Disseminate evidence generated to advocate policy makers to replicate this approach island wide.

EXPECTED OUTCOMS

  • Capacity building of human and technical resources for diabetes specific care services in the state and semi-government health care sectors in Colombo

  • To build effective bridges between preventive and curative health services in relation to diabetes care

  • To improve healthy life styles of the individuals, families and enhance community participation in the prevention of diabetes and cardiovascular disease in Sri Lanka

The final goal of the project was to generate the above evidence and thereby advocate policy makers and planners to replicate the approaches adopted in the project island wide.

The project aimed to prevent vulnerable communities from developing diabetes and its complications including CVD. It also aimed to improve the quality of diabetic care with enhanced secondary prevention in the delivery of care specifically in gestational diabetes and the diabetic foot. Since it particularly targeted the lower socio-economic groups, this project fulfilled the necessary criteria as a charitable project.

For achieving these aims, the project was executed in two Phases (Phase I: 2009-2012 and Phase II: 2013-2016)