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Planning,implementation and evaluation of education program on diabetes

Surakshya Poudel
Surakshya Poudel
Surakshya PoudelBPH Student at UCMS

Planning,implementation and evaluation of education program on diabetes

Planning,implementation and evaluation of education program on diabetes

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Planning,Implementation and
Evaluation of Education Program on
Diabetes (NCD)
Prepared and Presented by:
Surakshya Poudel
BPH 2nd batch (3rd yr)
UCMS
Introduction
• Diabetes is a chronic metabolic disease in which the person
has high blood glucose (blood sugar), either because insulin
production is inadequate, or because the body's cells do not
respond properly to insulin, or both.
• Hyperglycemia, or raised blood sugar, is a common effect of
uncontrolled diabetes and over time leads to serious damage
to many of the body's systems, especially the nerves and blood
vessels .
Types of Diabetes:
• Type 1 diabetes
(previously known as insulin-dependent, juvenile or childhood-
onset) is characterized by deficient insulin production and requires
daily administration of insulin .
The cause of type 1 diabetes is not known and it is not
preventable with current knowledge.
• Type 2 diabetes
(formerly called non-insulin-dependent or adult-onset) results
from the body’s ineffective use of insulin .
It comprises the majority of people with diabetes around the
world , and is largely the result of excess body weight and physical
inactivity.
Problem Statement
• The number of people living with diabetes and its prevalence
are growing in Nepal day by day.
• The epidemic of diabetes has major health and
socioeconomic impacts, especially in developing countries
like Nepal.
• The complications of diabetes can lead to heart attack,
stroke, blindness, kidney failure and lower limb amputation.
For example, rates of lower limb amputation are 10 to 20
times higher for people with diabetes.
Planning,implementation and evaluation of education program on diabetes
1. Social Diagnosis
The Social Factors leading to Diabetes in X ward of Y district are as
follows:
• Sedentary lifestyle i.e little or no physical activity
• Stress
• Overweight and obesity
• Unhealthy diet
• Tobacco and alcohol consumption
• Family history of diabetes
• Increased age
• Ethnicity
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Planning,implementation and evaluation of education program on diabetes

  • 1. Planning,Implementation and Evaluation of Education Program on Diabetes (NCD) Prepared and Presented by: Surakshya Poudel BPH 2nd batch (3rd yr) UCMS
  • 2. Introduction • Diabetes is a chronic metabolic disease in which the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body's cells do not respond properly to insulin, or both. • Hyperglycemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body's systems, especially the nerves and blood vessels .
  • 3. Types of Diabetes: • Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood- onset) is characterized by deficient insulin production and requires daily administration of insulin . The cause of type 1 diabetes is not known and it is not preventable with current knowledge. • Type 2 diabetes (formerly called non-insulin-dependent or adult-onset) results from the body’s ineffective use of insulin . It comprises the majority of people with diabetes around the world , and is largely the result of excess body weight and physical inactivity.
  • 4. Problem Statement • The number of people living with diabetes and its prevalence are growing in Nepal day by day. • The epidemic of diabetes has major health and socioeconomic impacts, especially in developing countries like Nepal. • The complications of diabetes can lead to heart attack, stroke, blindness, kidney failure and lower limb amputation. For example, rates of lower limb amputation are 10 to 20 times higher for people with diabetes.
  • 6. 1. Social Diagnosis The Social Factors leading to Diabetes in X ward of Y district are as follows: • Sedentary lifestyle i.e little or no physical activity • Stress • Overweight and obesity • Unhealthy diet • Tobacco and alcohol consumption • Family history of diabetes • Increased age • Ethnicity
  • 7. Health related factors • High blood pressure • High cholesterol/lipid levels • History of gestational diabetes • Impaired glucose tolerance(IGT) • Auto-immune system
  • 8. 2. Epidemiological assessment According to NDHS 2016, • 17% of women and 23% of men age 15 and older had hypertension at the time of the survey • 22% of women and 17% of men age 15-49 years old are overweight or obese • 27%of men and 6% of women use any type of tobacco • % of people with raised serum cholesterol/lipid level • % of people who consume alcohol regularly • % of people living with sedentary life style
  • 9. 3. Behavioral and Environmental Diagnosis Positive Behaviors • Regular Exercise • Maintaining ideal body weight • Regular Body Check-up • Healthy living practices • Reduction in stress taking habit • Prohibition of smoking and drinking alcohol • Intake of healthy diet • Low intake of junk food • Consult with physicians
  • 10.  Negative Behaviors • Sedentary lifestyle • Not maintaining ideal body weight(overweight or obese) • Taking stress • Habits of smoking and drinking • High intake of junk food • Inadequate care from family
  • 11. Decision Matrix LIST OF BEHAVIORS IMPORTANCE CHANGEABILITY TOTAL SCORE Regular exercise 5 4 9 Reduction of stress 4 2 6 Healthy eating practices 4 3 7 Regular body check up 5 3 8
  • 12. 4. Educational Diagnosis Predisposing Factors • 73% of people have idea about the diabetes. • 60% of the population thinks about diabetes happen when sedentary lifestyle survive. • 55% people having age 40+ have good knowledge about prevention of diabetes. • 70% of the people believe that governmental health facilities are of low quality • 80%believes that private sectors provide very effective medicines and treatment • 30% of the population didn’t know about cause and risk factors of diabetes. • 40 % of the population stated that they knew diabetes complication can occur during diabetes .
  • 13.  Reinforcing Factors • Family support • Health seeking practice in family • Healthy living practice in the family • Regular physician advice • Regular exercise
  • 14.  Enabling Factors • Access and Availability of health services regarding obesity, hypertension. • Availability of diabetes specialist (diabetologist) in hospital. • Different NGO/INGOs working for improving knowledge related to diabetes and its control. • Good referral mechanism for complicated cases. • Free diabetes checkup once in a month in health facility
  • 15. 5. Policy and Administrative Diagnosis Policy Diagnosis • The government has prioritized NCDs in the National Health Policy 2015 as well as National Health Sector Strategy 2015-2020. Administrative Diagnosis • MOHP, DOHS, Regional/Zonal hospital • Nepal Diabetes Association • Nepal Cardio diabetes and thyroid center • Kathmandu diabetes and thyroid center • OM hospital and Research center
  • 16. Goal  To reduce the mortality and morbidity resulting from diabetes in X ward of Y district within 60 days of health education program on diabetes.
  • 17. General Objective To reduce the incidence of diabetes by awareness program.
  • 18. Specific Objective At the end of the program: • 90% of adult will know the causes and risk factors leading to diabetes. • 70% of adult will start regular exercise for maintaining ideal body weight. • 80% of adult will start adopting healthy lifestyle and eating healthy diet • 95% of adult will be encouraged for regular health check-up.
  • 19. Target group • Adult people of age 18 yrs and above. • FCHVs • Local leaders Methods and Medias used • Methods:Drama ,Lecture,Group discussion,Demonstration • Media:Flipcharts,Posters/pamphlets,Multimedia
  • 20. Content of Health Education • Introduction of diabetes • causes and risk factors of diabetes • Effects of diabetes • prevention and control measure of diabetes
  • 21. 6. Implementation of the program • Detail plan of action using gantt chart will be implemented regarding health education program in diabetes after completely informing the target group. • Work-plan
  • 22. 7.Process evaluation • No. of health education session conducted • No. of supervision conducted • No. of review meeting conducted • Number of participants attended HE session
  • 23. Techniques of process evaluation • Pre and Post training evaluation • Regular monitoring of sessions and feedback in post session. • Question/ Answer Tools for process evaluation • (checklist, questionnaire)
  • 24. 8. Impact evaluation Assesses the changes in the KAP that occurred in the participants as a result of the Intervention like: • Quiting harmful dietary practices • Doing regular exercise Techniques of Impact evaluation • Household survey • Observation • Pre test/post test (assessment of knowledge)
  • 25. 3. Outcome Evaluation Identifying the changes in the health status of the participating group like: • Reduction in incidence of heart disease • Reduction in mortality and morbidity rates due to diabetes Achievement of these indicators will show the outcome of the health education program whether it has been successful or not
  • 26. Follow up • Without proper follow up ,the program cannot be sustainable. So follow up will be done every month for two years by the help of FCHVs and health facility staffs.
  • 27. References • NDHS 2016 • https://clinicaltrials.gov/ct2/show/NCT03304158 • http://nhrc.gov.np/projects/non-communicable-disease-risk-factors- steps-survey-nepal-2018/