QualiDia Project: health education for self-management and quality continue evaluation of diabetes care in Brazil

Abstract

The Chronic Non-Communicable Diseases (CNCDs) are a global health problem and a threat to health and human development, with the burden of these diseases mainly in low and middle-income countries. Brazil is going through a rapid demographic and epidemiological transition with an aging population and the prevalence of chronic diseases. The high prevalence of morbidity and mortality associated with diabetes and its complications have a significant impact on the Unified Health System (SUS), especially for municipal healthcare management. The SUS has a wide range of activities and services that enables a comprehensive care for diabetes prevention and control, which must be reorganized and articulated in a new healthcare model. It is necessary, however, to have evidence of feasibility and practicality of this new model for SUS. Successful international experiences in chronic care management - diabetes in particular - should be guiding the country to develop proposals adapted to the Brazilian reality, in order to contribute to the redesign of existing national programs and policies on CNCDs in SUS. It is reported in this paper the development of a pilot project called QualiDia, designed to strengthen and expand the actions of SUS concerning self-care education, advocacy, community mobilization, continuous assessment and improvement of diabetes care management. The project used logical framework methodology from which four expected outcomes were settled. A convenience sample of ten municipalities was selected, based on certain inclusion criteria to participate as demonstration areas. For the structure of the project, which will last for sixteen months, an activities schedule was established for its implementation. The selected municipa[1]lities agreed to participate in these activities and signed Terms of Agreements with the coordination of the project. A diagnosis of the health care situation for people with diabetes has been prepared for each municipality. It is expected this project could bring, as a result, tools that can support national, state and local health authorities, in the formulation of strategies and the implementation of integrated actions on CNCDs care.