Clubs of diabetic and hypertensive for better health at latter life: An experience from a local initiative in Chakaria, a rural area of Bangladesh

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1 Clubs of diabetic and hypertensive for better health at latter life: An experience from a local initiative in Chakaria, a rural area of Bangladesh Click to edit Master subtitle style Shahidul Hoque, Ariful Moula, Mohammad Iqbal, SMA Hanifi, Mijanur Rahman & Abbas Bhuiya

2 Introduction Chakaria Community Health Project of ICDDR,B has been working at Chakaria from 1994 to foster community participation in health activities. The community initiate 7 village health posts in 6 union which is an unique and exceptional health initiative in this region. Chronic disease clubs are a village health post initiatives.

3 Background Globally diabetes and hypertension contribute as one of the 5 leading mortality risks and constitute as public health challenge. Bangladesh has evidences of death due to NCDs: Lack of physical activity Inadequate intake of vegetables and fruits. Bangladesh is showing an upward trend in the prevalence of diabetes (6.9%) and hypertension (12%)

4 Background (cont d) Life style modification may alter the upward trend in the prevalence of diabetes and hypertension and associated risks of mortality Change in life style in later age Non-pharmaceutical measures Social capital and physical activity as base Not enough evidence on community based life style modification focused behavior change intervention

5 General Objectives To study the possibility of engaging older people aged 40 years and above in the self initiated NCD clubs. Specific: a) b) c) Initiate testing of blood glucose and BP in order to raise awareness on diabetes and hypertension. Motivate older people at risk and diagnosed with diabetes/hypertension to form community NCD clubs. Provide health education for group activities for walking, modified life style and diet habit, experience sharing on success and failure in controlling the disease

6 Methodology Site: Rural Bangladesh Chakaria sharing characteristics of a typical poor rural Bangladesh located at the south eastern part of the country having both plain and hilly lands and costal belts. Beginning: November, 2009 Status: Ongoing Resources: Mobilized by the village health post

7 Methodology (cont d) From 2 village health posts/union, one (old) ward selected from each. All belonging to the selected age-group ( 40) in 2,842 households, were formally invited to participate in the screening for diabetes and hypertension. Standard procedures of measuring blood pressure and glucose were followed. Community paramedics and midwives are responsible for measuring blood pressure and fasting blood glucose. The persons screened for diabetes and hypertension are mobilized to form a club or organization in their respective areas.

8 Methodology (cont d) Partnering with village health posts, regular club meetings were facilitated to discuss life-experiences, take blood glucose and pressure regularly, and take appropriate measures. Their health behavioral practices are being observed. Narratives of club meetings are recorded and were manually analyzed to identify their activities and initiatives taken. Recording of blood glucose, pressures, and socioeconomic conditions of the participants

9 Results By June (female 10, male 7) clubs of diabetic and hypertensive have been formed by the patients and their fellows; 145 meetings of these clubs were held. Most meetings discussed their daily lifestyles and planning to walk together in the morning or evening, avoid oily and fatty foods, and give up tobacco.

10 Result (cont d) All the members (n=426) are checking their blood glucose and pressure at the meeting, consulting graduate physicians with a mobile phones when needed. 45% of the club members walk together with their fellow members compared to none before.

11 Results (cont d) 3,350 people aged 40 years and above were listed and invited in the session, more than half (1877) participated in the screening sessions. Among the screened 532 person had hypertension, 110 had diabetes and 29 had both condition. Females are more likely to at risk of hypertension than male counterpart.

12 Conclusion It is possible to mobilize the aged people under a common platform for taking collective initiative and work together to reduce the risks of chronic disease condition with meaningful participation through local community or organizations. More research is needed to observe these local organizations for health benefit at latter age and ways to integrate the model to government services.

13 Patients registering for screening

14 Paramedic measuring blood Glucose

15 Paramedic measuring blood pressure

16 Club meeting

17 Health education

18 Thank you