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Project Summary
Diabetes currently affects around 30% of the adult population of听Bangladesh either as pre-diabetes or fully expressed diabetes听mellitus. The problem of diabetes and its complications is a growing听concern among communities, health service providers and听policymakers, yet raw data on the magnitude and underlying causes听of the problem are scarce, especially in rural areas. Underlying the听increasing prevalence in Bangladesh are patterns of dietary change,听changing lifestyles and increases in other risk factors like lack of听exercise and smoking.听
Our study is part of the /MRC diabetes research initiative and seeks to听generate data on disease and risk-factor prevalence in rural villages听in Faridpur district. We will also evaluate two interventions to improve听the detection, management and prevention of diabetes in these听deprived populations.
The first is an 'mHealth' intervention that will听use mobile phone technology to send health promotion information听and targeted diabetes prevention and management messages to the听population. The second intervention will focus on participatory听community groups, engaging communities in a series of meetings in听which the population themselves identify and address factors that听may increase their risks of diabetes or prevent the effective听management of the disease.
This approach has proved highly听effective in relation to neonatal health but ours is the first study of its听kind to evaluate impact of the approach on a chronic, non-communicable illness such as diabetes. It is hypothesised that听collective community messaging and engagement in this way will听enhance awareness and trigger behaviour change leading to lower听burdens of risk factors and disease indicators, measured through听large community surveys.
The simultaneous evaluation of the two听interventions in different areas will allow a comparison of the benefits听of each compared to a 'control' area that only receives standard听diabetes prevention and care services. A strong focus on听implementation and process evaluation will identify the likely听scalability and sustainability of these interventions should they prove听effective.
