Diabetes is one of the four non-communicable diseases responsible for highest mortality and morbidity across the world. It is covered in the essential services packaged to be provided at primary health care facilities (PHC) in Khyber Pakhtunkhwa (KP). However, an effective system to prevent and facilitate the treatment of the disease at this level is not operational. As a result, in a majority of cases, people get to know they are sering from disease when they start seeing early signs of complications. The pilot has established a system to Identify pre-diabetic/diabetic patients at an early stage to save them from complications. A manual has been developed in consultation with experts, doctors and paramedic staff trained, and a registration and referral system operationalized for this purpose. The model also includes behavior change interventions to promote awareness of the disease.
The DDCF awarded a grant of PKR 58.8 million of which PKR 47.6 million has already been disbursed. The pilot started in September 2014 with the expected closing date of June 2017.
Pilot Beneficiary, Results and Impact
The D-TALK pilot targets about 34,000 beneficiaries including some 52% women and about 85.7% rural populations in the 6 districts. Actual number of beneficiaries is likely to exceed the target. However, specific information and disaggregated data on beneficiaries would become available only after the project ends in June 2017.
Adotion and Scale-Up Status
An MoU has been signed between the Health Department (HD) KP and SNG. A Special Steering Committee for DDCF Round 2 pilots housed in Health Department oversees the progress. District Oversight Committees, established in the six SNG districts, review progress periodically. The SNG is working with the Health Department and the implementing partner on preparing a PC-I for the adoption of this model in phases across the province.
Economic Cost-Benefit Analysis of Scale-up
Average cost of implementing the model in one district is estimated at 25 million per year. At this rate, it will cost approximately PKR 700 million to adopt this model across the province. This needs to be done preferably in three phases to ensure that the new practices are properly embedded in health care apparatus. The cost for each phase will be around PKR 225 million. The project shall help in early detection and treatment of disease in 8,000-9000 patients (average cost PKR 3000/patient) per district. Aside from this core group of beneficiaries, the project shall ensure that all patients who visit PHC facilities are screened for the disease. This will benefit millions of peoples.
Department of Diabetes and Endocrinology, Postgraduate Medical Institute, Hayatabad Medical Complex, Peshawar.