Project HOPE: Five Lessons From the Global Fight Against Diabetes

Barbara Smith, MPH, CDPM, is a senior program officer for Project HOPE, where she oversees the non-profit’s noncommunicable disease programs.

Project HOPE is a global health and humanitarian organization that has been working to transform the health and well-being of people around the world for the past 65 years. Since 1996, we have worked specifically on increasing education, prevention, quality care, and treatment access for type 2 diabetes, gestational diabetes, and pre-diabetes.

Healthcare Workers Matter

A large focus of our work is training healthcare workers to improve skills in the care and treatment of various diseases and health issues. Because of our long history of strong partnerships and leaders that sought to bridge gaps in healthcare and reach those most in need, Project HOPE was the first NGO to create noncommunicable disease programs in 1996 with an assessment of the diabetes epidemic in China.

To do so, we work with healthcare professionals, community health workers, people living with diabetes, people at risk of diabetes, adolescents, and school-aged children. We have used online education, mHealth, telehealth, clinic-based health, and peer support to build the capacity of health systems to improve access to and standardize care.

Our 1998 NCD assessment in China opened the door to a portfolio of diabetes programs that has spanned nearly 20 years. In China, Project HOPE started out training tertiary level healthcare professionals in the delivery of diabetes-related health services, who then trained colleagues down to the community health level. We worked with communities and, more specifically, families of people living with diabetes, to educate them about the disease and how best to care for their loved one. In addition, we developed a nationally recognized diabetes education curriculum innovative community-based total diabetes care networks that helped to fill gaps where little to no care for diabetes existed.

A recent Project HOPE training session in China.

Diabetes is Global, and Awareness Still Needs to Improve

In 2003, the Project HOPE Mexico team developed an innovative diabetes self-management education curriculum called 5 Steps to Self-Care aimed at reaching the inner Mexico City migrant workers and their families with a game-based, simple language means of teaching people with low-literacy on what the risks for diabetes are, including questions related to how did they get it, what is diabetes, what changes happen in the body, and what you can do to live a better, longer life with diabetes. The success of the 5 Steps to Self-Care course in Mexico at improving both clinical and mental health has led to Project HOPE launching six additional cultural adaptations in South Africa, India, Puerto Rico, United Arab Emirates, the Bahamas, and China. Every one of these programs have shown similar results in improving both clinical and mental health among participants. Over and over, our trained healthcare providers are told by the participants that this was the first time they understood what diabetes is and that they could have a better quality of life with diabetes.

Patients Must Be Empowered to Thrive

In partnership with AstraZeneca’s Young Health Programme (YHP) Mexico, Project HOPE aims to prevent the most common non-communicable diseases (NCDs) such as cancer, diabetes, heart disease, and respiratory disease through empowering young people to manage their health. Through the YHP’s unique Peer Education training approach, young people from diverse backgrounds are equipped with health information and skills which they use to train other young people in their community on health topics including NCD prevention. This empowers them to manage their own health, and speak up on the health issues that matter to them. By engaging with their families, peers, community leaders, and policy-makers on how to affect change on a greater scale they become change-makers within their communities.

Healthy Habits Start with Childhood

YHP Mexico also implemented the Healthy Habits for a Healthy Weight program with the aim of helping to reduce NCD risk factors contributing to obesity among third-grade school children. This program involved parents, teachers, and students and combined education, screening, and care for those diagnosed with diabetes. Students developed capacity in understanding the impact of healthy habits, such as eating five servings of fruits and vegetables every day, drinking at least two liters of water – instead of sugary beverages – and the importance of physical activity for at least 60 minutes every day.

Gestational Diabetes is Too Rarely Discussed

In Mexico and Nicaragua, Project HOPE has trained healthcare workers to promote universal testing for gestational diabetes (GDM) among pregnant women. This program increased access to treatment to reduce maternal-child death and illness with the goal of breaking the cycle of increased diabetes risk by increasing early detection, treatment, and prevention education. In addition, the program used text messaging to reach additional pregnant women in the participating communities with GDM and prenatal educational messages.

Project HOPE

2023 marked the 25th anniversary of Project HOPE’s work to combat the global epidemic of diabetes. Over the past 25 years, Project HOPE has:

Trained over 5,300 healthcare workers on diabetes screening, care and treatment;
Reached over 12,500 people living with diabetes with self-management education and improved access and quality of care; and
Reached over 636,000 community members with diabetes prevention and educational messages.

Project HOPE believes everyone deserves access to the healthcare they need to reach their full potential.  We will continue to work to combat the rise in diabetes around the world by improving the skills of healthcare workers to improve access to quality diabetes healthcare in communities with the most need.

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