Abstract Details

Session title: Education and development for healthcare professionals Session type: Poster - Education and Integrated Care Track: Education and Integrated Care

Presentation number: P-1075

Abstract title:

Tackling diabetes epidemic through focused primary care provider training: India's largest regional center's experience

Presenting Author: Kuntikana, A


Background

The huge burden of diabetes in India, needs a corresponding quantum of qualified and trained diabetes care physicians. National capacity building for management of diabetes has to be strengthened by improving knowledge and clinical skills of physicians treating diabetes, especially in semi urban and rural areas. Well- planned short / longer term training programs are useful in improving knowledge and in creating enthusiasm to improve diabetes care and awareness for the communities and nation at large.

Aim

To analyse: (a) the profile, performance and progress of the Primary Care Physicians - PCPs enrolled and trained at Jnana Sanjeevini Diabetes Hospital and Medical Center, Bangalore, between 2010 and 2017, and (b) the potential positive differentiating factors contributing to the highest national performance at this Regional Center [RC].
Public Health Foundation of India, in partnership with regional specialty diabetes centres, has implemented [2010] a novel Primary Care Physicians PCP Training and Certification program. In this national effort, JSMC, Bangalore, has been the top most RC, with highest enrollment and empowerment of PCPs. [National Expert: Dr S Srikanta; Regional Faculty: Dr A Sharda, Dr Tejeswini Deepak.]

Public Health Foundation of India (PHFI), is an autonomous foundation located in New Delhi, India. The foundation was created as a public-private initiative in 2006 with the aim of enhancing the capacity of public health professionals in the country over future years.

Samatvam non-profit charitable public trust (Science and Research for Human Welfare Trust), initiated by a group of medical and social volunteers in 1987, with a focus on health care, medical education, research and social welfare. Jnana Sanjeevini Diabetes Hospital and Medical Center is a dedicated public service project of Samatvam Trust. The beneficiaries of its Program DEEPA (Diabetes Education Enrichment Practice and Accreditation) are Physicians, Diabetes health counsellors / educators / community health workers.

Method

Number of courses= 13 [Distance education PLUS one module of 8 hours per month; theory, case discussions, practical demonstrations]; PCPs enrolled: 518 [1-4 courses per PCP] (a) Certificate course in Evidence Based Diabetes Mellitus (CCEBDM)= 4 [12 modules]; Number of PCPs= 172 (b) Certificate Course in Gestational Diabetes Mellitus (CCGDM) = 4 [4 modules]; Number of PCPs= 108 (c) Advanced Certificate Course in Prevention and Management of Diabetes and Cardiovascular Diseases (ACMDC)= 2 [6 modules]; Number of PCPs= 114 (d) Certificate Course in Management of Thyroid Disorders (CCMTD) = 4 [4 modules]; Number of PCPs= 123.

Feedback was obtained from participants using online survey.

Results

[Means] Age at enrolment= 38 y [24-67]; Maximum enrolment = 47% between ages 25-34 years; Years of medical practice before enrolment= 17 y; Distance from RC= 116 kms [rural and urban]; Increase in number of diabetes patients being served by PCPs after course completion= 38%; PCP + Postgraduate Specialist Qualifications = 66% [including obstetricians, pediatricians, surgeons, radiologists, oncologists; academic physiologists, biochemists, pharmacologists, community medicine]; Institutional affiliation: Private solo= 85%; Government= 10%; Medical College faculty= 23% [some dual roles]. Satisfaction with the courses: Extremely satisfied= 73%, Moderately satisfied= 21%; Student positive feedbacks: 'Most confidence filling; Very informative, clinically oriented; Very practical; Holistic approach"; 'Some of real cases discussed make us remember the entire topic"; 'Methodical approach, starting from basics". Suggestions for improvement: 'Short term internships at Diabetes Center; Web based continued education."

Discussion

A centrally designed and regionally implemented PCP Diabetes Care Training and Certification Program, has been highly successful in diabetes medical manpower enrichment [quantity and quality] in India. Besides good course content, 'going beyond the syllabus" and 'motivational and inspirational pedagogy" [role model teachers] are crucial. This has led to delivery of improved diabetes and overall medical care in the communities' served. This program can be further improved and replicated in other countries.

Tackling diabetes epidemic through focused primary care provider training: India’s largest regional center's experience