Developing countries bear the diabetes brunt
The burden of diabetes in developing countries has rapidly overtaken that of their developed counterparts. Country case studies from the “diabetes and development” sub-plenary were heard from Brazil, Cameroon and India. Brazil is working towards universal and free access to all prevention and management resources for diabetes based on the principles of primary health care and thus health systems strengthening. Cameroon has shown how prevention and control measures are possible even in resource poor settings by integrating and building capacity into existing services. Peer support groups, run and managed by their members have shown to be highly effective. India has shown that prevention measures, institutionalized into school curriculums can significantly reduce childhood overweight and obesity. This initiative is directed at multiple factors including child, family and teachers as well as the environment which creates the structure to enable change.
Pre-organised calls for action included:
1. Create universal and affordable access to information and care to avoid the vicious poverty cycle;
2. Strengthen health systems with; integrated chronic disease management; cultural appropriateness and improved maternal health interventions for the earliest prevention measure - healthy birth weight;
3. Create suitable and cost effective entry points for initiating such activities at primary care and grass root levels.
The reaction from the floor was that;
· Point 2 must incorporate changes in the environment and social determinants of health from top down policy that is created via bottom up demand.
· .Addressing maternal health for healthy birth weight must also include breastfeeding and early child development approaches
Some crucial “missing” areas brought up by the floor included the importance of the incorporation of oral, sexual, and late disease stage health. In addition, the issue of “how to” make sure that effective interventions are reaching those most disadvantaged was raised. For example, resource poor schools can be missed and those children who remain unable to access school will definitely be missed. How can initiatives to address diabetes be more equitable? How can interventions best address from the life-course continuum of earliest prevention to management at later stages of disease? Please comment!
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Diabetes health fairs as educational interventions
Thank you @brinke for posting these thoughtful reflections. Type 2 diabetes is a life-style issue and is well prevented and managed through nutrition, weightloss, exercise and other life-style modifications. Education campaigns and health fairs have been used in various contexts with good results. The typical event combines awareness for prevention with education for self-management aimed at patients and their families. Ideally, organizers invite health professionals, nutritionists... to offer talks, demonstrate cooking recipes, conduct free health screenings and distribute information. It would be critical to involve community programs, resource centres, women's programs, schools...etc to mobilize awareness that diabetes concerns the whole community. Events like these present a logistical challenge to bring service providers together, find sponsors to pay for the screenings and market the event effectively but can be beneficial in reaching all groups in the community - and promoting all aspects of primary health care. This kind of setting provides an opportunity to disseminate plain language information in writing as well as convey the message verbally - including the use of song, dance and theatre.
Poor resource environments face enormous challenges but recognizing diabetes as a priority is the first step to integrating its prevention and management into the overall primary health care agenda and allocating the requisite resources.