Capacity-building of the allied health workforce to prevent and control diabetes: lessons learnt from the National Initiative to Reinforce and Organize General Diabetes Care in Sri Lanka (NIROGI Lanka) project

In 2008, to tackle the exponential rise in the clinical burden of diabetes that waschallenging the health systems in Sri Lanka, a shift in focus towards patientcentred care linked with community health promotion was initiated by the NationalInitiative to Reinforce and Organize General Diabetes Care in Sri Lanka (NIROGILanka) project of the Sri Lanka Medical Association. Specific training of “diabeteseducator nursing officers” (DENOs), field staff in maternal and child health, footweartechnicians, and health promoters from the community, was instituted to improveknowledge, skills and attitudes in the area of control and prevention of diabetes.This article highlights some of the activities carried out to date with the allied healthworkforce and volunteer community. Specifically, it describes experiences withthe DENO programme: the educational and administrative processes adopted,challenges faced and lessons learnt. It also highlights an approach to preventionand management of complications of chronic diabetic foot through training acohort of prosthetics and orthotics technicians, in the absence of podiatrists, andan initiative to provide low-cost protective footwear. Harnessing the enthusiasmof volunteers – adults and schoolchildren – to address behavioural risk factorsin a culturally appropriate fashion has also been a key part of the NIROGI Lankastrategy.

Abdominal obesity in females: a problem in South Asia receiving insufficient attention / 中华医学杂志(英文版)

Abdominal obesity (AO) has become a major health problem to most of the Asian communities. The severity and consequences of AO are higher among females. It has virtually become an epidemic in most South Asian countries and the health care systems in this region are likely to be challenged by one of the biggest health issues in the near future. Yet, the recognition of the magnitude of the problem by health authorities is poor. The purpose of this paper is to motivate health care professionals, planners and policy makers towards better control of the epidemic of AO while highlighting the paucity of evidence on clinical management of AO from the South Asian region.