International Diabetes Federation

Capacity Building Capacity Building Diabetes Project

(2007-2009)

Cardiovascular Disease Project (2010-2013)

Davao City, Philippines

Capacity Building Capacity Building Diabetes Project

(2007-2009)

Cardiovascular Disease Project (2010-2013)

Davao City, Philippines

Contents

• Handicap International• Philippine Context• The Diabetes Project• The Cardiovascular Disease Project• Challenges• Key Results• Lessons Learned

Handicap International (HI)

AssociationAssociations worldwide s worldwide form the form the Handicap Handicap International International FederationFederation

France France Switzerland Switzerland Luxemburg Luxemburg Germany Germany United Kingdom United Kingdom Canada Canada United United States States Belgium Belgium

Why is HI involved in the fight against diabetes?

• Because every 30 seconds, a leg is amputated somewhere in the world because of diabetes.

• Because diabetes is a disabling disease for 20-50% of diabetics.

• Because countries with limited resources are the worst affected by the diabetes “epidemic”, and the poorest communities in particular.

HI and its Partners Can……..

1. Strengthen local associations of persons with diabetes

2. Strengthen health facilities with training, equipment and networking

3. Improve therapeutic patient education

4. Facilitate access to drugs and biological examinations for all

5. Encourage primary prevention in partnership with the state and local organisations

6. Prevent diabetic foot by:

a) educating on foot care, b) adapted footwear, c) orthoses or prothesis, d) foot care by health care providers

HI and its Partners Can……..

7. Support rehabilitation for diabetic persons with disabilities

8. Promote inclusion of persons with diabetes in:

a) Society and family, b) The world of work, c) Education, d) Sports and leisure activities

9. Engage in advocacy directed at the international community and the governments of countries with limited resources to make diabetes a public health priority.

Philippines

Population in 2010 : 94 million Barangays – smallest unit of government

with a highest population of 222,000.

DIABETES AND CVD Diseases of the heart (1), vascular system (2) and

diabetes (8) leading causes of mortality. Diabetes prevalence: 7.6% (2007) and 9.3% (2025) Among the top 10 countries with highest number

of diabetes cases by 2030. Leading risk factors by rank :

• Smoking (35%)• Hypertension, • Obesity, • Hypercholesterolemia • Diabetes

Davao City

Davao City

Davao City before the Diabetes Project

The Diabetes Project

Aims to increase access to multidisciplinary, integrated diabetes management at the level of communities.

Using a Local Inclusive Development Approach

Capacity building of: Service providers Self-help groups Policy makers

The Diabetes Project

Capacity building of health and rehabilitation service providers by:

1.Training of primary health care professionals and community health workers

2.Develop systems and tools for General information Patient education Health service provision

and referral

3.Skills upgrading of prosthesis and orthotics technicians

The Diabetes Project

The Diabetes Project

The CVD Project

TITLECapacity Building Project for the Prevention of Complications and Disabilities Linked to Cardiovascular Disease.

MOTTO

Building Partnerships, Improving LivesLocal Inclusive development Replication of good practices now covering the entire city Emphasis on partnership building Sustainability

The CVD Project

Capacity Building of Health and Rehabilitation

Service Providers

Organisational Development of Local Diabetes Support Groups

Awareness Raising

AdvocacyEstablishing Peer

Education

Availability of Health Services

Increasing the demand for the

services

Policy Development for institutionalization

and funding among others

ENABLING ENVIRONMENT FOR: •Lifestyle change•Delivery of Quality, sustainable service

Prevent Complications, Reduce Disabilities, Improve Lives

Building Partnerships

1. City Government / City Health Office – primary implementer, policies, budget

2. Department of Health – Healthy Lifestyle Campaign, Technical Support

3. Southern Philippines Medical Center – technical support, referral institution

4. Davao Jubilee Foundation –technical support, referral institution

5. Handicap International – coordination, technical support, funding

Building the Capacity for Service Provision:

Strengthen and build on existing Primary Health Care Services through:1. Training for service providers and trainers of service providers2. Processes and tools development3. Setting up laboratory services

Building the Capacity for Service Provision:

Strengthen and build on existing Primary Health Care Services through:1. Training for service providers and trainers of service providers2. Processes and tools development3. Setting up laboratory services

Building the Capacity for Service Provision:

Strengthen and build on existing Primary Health Care Services through:1. Training for service providers and trainers of service providers2. Processes and tools development3. Setting up laboratory services

Building the Capacity for Service Provision:

Strengthen and build on existing Primary Health Care Services through:1. Training for service providers and trainers of service providers2. Processes and tools development3. Setting up laboratory services

Building the Capacity for Service Provision:

Strengthen and build on existing Primary Health Care Services through:1. Training for service providers and trainers of service providers2. Processes and tools development3. Setting up laboratory services

Building the Capacity for Service Provision:

Strengthen and build on existing Primary Health Care Services through:1. Training for service providers and trainers of service providers2. Processes and tools development3. Setting up laboratory services

Building the Capacity for Service Provision:

Strengthen and build on existing Primary Health Care Services through:1. Training for service providers and trainers of service providers2. Processes and tools adaptation and development3. Setting up laboratory services

Building the Capacity for Service Provision:

Strengthen and build on existing Primary Health Care Services through:1. Training for service providers and trainers of service providers2. Processes and tools adaptation and development3. Setting up laboratory services

Building the Capacity for Service Provision:

Strengthen and build on existing Primary Health Care Services through:1. Training for service providers and trainers of service providers2. Processes and tools adaptation and development3. Setting up laboratory services

Building the Capacity for Service Provision:

Strengthen and build on existing Primary Health Care Services through:1. Training for service providers and trainers of service providers2. Processes and tools adaptation and development3. Setting up laboratory services

Building the Capacity for Service Provision:

Strengthen and build on existing Primary Health Care Services through:1. Training for service providers and trainers of service providers2. Processes and tools adaptation and development3. Setting up laboratory services

Building the Capacity for Service Provision:

Strengthen and build on existing Primary Health Care Services through:1. Training for service providers and trainers of service providers2. Processes and tools adaptation and development3. Setting up laboratory services

Building the Capacity for Service Provision:

Strengthen and build on existing Primary Health Care Services through:1. Training for service providers and trainers of service providers2. Processes and tools development3. Setting up laboratory services

Organizational Development :

Strengthen and build on existing Local Diabetes Support Groups (LDSG):1. Organization development and project development trainings2. Establishment of Peer Support3. Support the formation of an LDSG federation

Organizational Development :

Strengthen and build on existing Local Diabetes Support Groups (LDSG):1. Organization development and project development trainings2. Establishment of Peer Support3. Support the formation of an LDSG federation

Organizational Development :

Strengthen and build on existing Local Diabetes Support Groups (LDSG):1. Organization development and project development trainings2. Establishment of Peer Support3. Support the formation of an LDSG federation

Organizational Development :

Strengthen and build on existing Local Diabetes Support Groups (LDSG):1. Organization development and project development trainings2. Establishment of Peer Support3. Support the formation of an LDSG federation

Organizational Development :

Strengthen and build on existing Local Diabetes Support Groups (LDSG):1. Organization development and project development trainings2. Establishment of Peer Support3. Support the formation of an LDSG federation

Organizational Development :

Strengthen and build on existing Local Diabetes Support Groups (LDSG):1. Organization development and project development trainings2. Establishment of Peer Support3. Support the formation of an LDSG federation

Awareness Raising:

Awareness Raising:

Awareness Raising:

Advocacy:

Advocacy:

Challenges:

1.Charity mindset2.Building a participatory environment3.The politics of health4.Task shifting5.Public’s lack or urgency

Davao City Today:

Health Services:

Services institutionalized with 178 Barangay Health Centers offering services for diabetes and CVD

Laboratory services established in the 14 District Health Center and the City Health Office main laboratory

3,845 screened for diabetes and other risk factors 2,312 registered / enrolled in the CVD program

26 Diabetes Educators (CVD Program Trainers) 252 Trained Primary Health Care Professionals 1641 Trained Community Health Workers

Davao City Today:

Organisations 4 organisations with legal identities 374 organisation members 2 organisations with peer support committees with 19 peer support

volunteers Federation of 6 Local support groups formed

Policies developed: CVD Program Partnership World Diabetes Day every November 14 World Heart Day every September 29 Revision of the City Tax Code to include laboratory services

Proposed budget of 20 million for 5 years

At least 1 year is needed to:1)Establish name and credibility

2)Introduce the project and the approach

3)Develop relations with stakeholders and establish trust

4)Define stakeholder roles

5)Formalize partnerships

6)Define strategies and activities with project partners

7)Organise and capacitate the project team

8)Conduct a proper baseline study

During project development give time for building solid foundations

Lessons Learned:

1. Consistency of approach

2. Look for a champion/s

3. Define next steps with relevant stakeholders

4. Participatory definition of stakeholder roles

5. Institutionalise the partnership

6. Create a working structure

Lessons Learned:

Looking Ahead:

Manual of Operations forNon Communicable Disease Prevention and Control

Federation of Local Diabetes Support Groups

Health and Rehabilitation

Service Providers

Academe

City Social Services

City Engineers

Office

MULTISECTORAL APPROACH

MAINSTREAMING NCD INTERVENTIONS

City Sports Office

City Information

Office

City Agriculture

Office

Association of Barangay

Captains

Student Organizations

Professional Medical

Organizations

DAVAO CITY