Photo © by Novo Nordisk

Fighting diabetes in pregnancy in Colombia

Diabetes among pregnant women is a rising phenomenon. One in seven births is affected by a temporary form of diabetes known as gestational diabetes or ‘GDM’.  Resource constrained countries are hit particularly hard, as three out of four people with diabetes live in low- and middle-income countries.
In 2011 a multi-stakeholder project called “Vida Nueva” – or ‘New Life’ - was launched in Colombia to address these challenges.

In Colombia, public awareness on diabetes in pregnancy and its potential harmful consequences is very low. Testing for diabetes during pregnancy is not common practice.
Therefore the Colombian NGO Centro de Investigación Sanitaria (CIIS), Novo Nordisk – a global healthcare company with its headquarters in Denmark and a range of local partners, set up a project with support from the World Diabetes Foundation (WDF) and Novo Nordisk in the city of Barranquilla in Colombia.

Local ownership

The initial project idea was conceptualised by Novo Nordisk and CIIS, but not long into the project design-phase, the local municipality in Barranquilla got involved.
Since then, the municipal authorities have been the main driver and coordinator of the project, in charge of mobilising and engaging the local community, and of training healthcare professionals in GDM testing and management.
“Working with an engaged local partner is key for ensuring local anchoring of the initiative and sustainability of the changes introduced by the time the project comes to an end,” says project manager Rikke Fabienke. “While only data over time will show the long-term impact, we believe that this approach holds one of the keys to prevent future diabetes and reduce the complications that the condition can entail.”

From the beginning of the project there has been a clear division of roles and responsibilities among the various project partners; each partner has contributed to a specific component based on its competencies. The World Diabetes Foundation (WDF) and Novo Nordisk have been less involved in the day-to-day project implementation, but have primarily contributed on a strategic level with knowledge transfer and experience sharing from other diabetes projects.

Local project ambassadors

A key learning has been that having a passionate and dedicated local project management team, which can act as project ambassador and gather local actors around a joint cause, ensures visibility and  leads to real change in local health systems and practices.
In Barranquilla, project efforts have resulted in a significant rise in awareness of diabetes in pregnancy among pregnant women, making the local health service provider adapt its approach to maternal health to include testing for and management of gestational diabetes. The strong local ownership has also been key to ensure sustainability of the activities after the project ended.

Systemic change and increased awareness

In order to measure the impact of the Vida Nueva project local universities have been engaged in collection and analysis of data on maternal health during the project period. Within the three-year project frame, Vida Nueva has succeeded in creating a range of measurable results in Barranquilla.
The project has trained more than 1,200 community health workers in the implications of GDM and the importance of getting tested at the right time. The community health workers have played a key role in reaching out to the pregnant women through home and community visits, ensuring their participation in GDM education sessions, as well as in following up on the women, who were diagnosed with GDM.
“In many countries, testing for gestational diabetes is not a part of the general care for pregnant women, and many countries lack testing and management guidelines as well as trained healthcare professionals. The ‘Vida Nueva project has dramatically increased the number of pregnant women that are being tested for GDM and managed to bring their blood sugar in control,” says Rikke Fabienke, Global Project Manager for Novo Nordisk’s Changing Diabetes® in Pregnancy programme.

Novo Nordisk
Novo Nordisk is a global healthcare company with more than 90 years of innovation and leadership in diabetes care. This heritage has given us experience and capabilities that also enable us to help people defeat other serious chronic conditions: haemophilia, growth disorders and obesity. Headquartered in Denmark, Novo Nordisk employs approximately 40,300 people in 75 countries and markets its products in more than 180 countries.

The World Diabetes Foundation (WDF)
The World Diabetes Foundation is an independent trust dedicated to the prevention and treatment of diabetes in the developing world. The Foundation creates partnerships and acts as a catalyst to help others do more. The World Diabetes Foundation strives to educate and advocate globally in an effort to create awareness, care and relief to those impacted by diabetes.

Alcaldía de Barranquilla (The Municipality of Barranquilla)
Barranquilla, located in the northern region of Colombia, is the fourth largest city in the country. It has been recognised as a leader in innovative health and education models in Colombia. In the Vida Nueva partnership, the municipal authorities of Barranquilla have been in charge of mobilising and engaging the local community and the training of healthcare professionals in GDM testing and management.

Centro de Investigación Sanitaria (CIIS)
CIIS is a local Colombian NGO working to promote public awareness of healthcare issues and ensuring healthcare for low-income communities. CIIS was one of the driving forces behind the conceptualization of Vida Nueva project. Hereafter, the municipal authorities have managed and coordinated the project implementation, while CIIS has been in charge of developing the training- and awareness material and handling the project finances.

Other project collaborators:
The Steno Health Promotion Center (SHPC), Colombian Diabetes Association, Colombian Association of Endocrinology, Universidad del Norte; Universidad Libre, Universidad del Atlántico, HJELT Institute at University of Helsinki, Finland, and The Department of Obstetrics (Diabetes in Pregnancy) at the Danish National Hospital in Copenhagen.

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