Program Aims to Address Non-Communicable Diseases in Underserved Communities Through Training, Screening and Access to Care
AMPATH/MAPAS México is poised to combat diabetes and related non-communicable diseases (NCDs) in resource-limited communities in Puebla, Mexico, through a strategy that combines health workforce development with community-based health promotion, screening and care to individuals in the impacted communities otherwise adversely impacted by NCDs.
The new 3-year initiative is supported by a donation of more than $3 million USD from Eli Lilly and Company to Indiana University Foundation, which will be used to support Indiana University’s supportive efforts to AMPATH to build community capacity and strengthening health systems for non-communicable diseases in rural, underserved communities in Puebla, Mexico. Indiana University leads the AMPATH Consortium of universities around the world working toward a vision of ensuring health for all.
“This program will build on successful AMPATH models of partnership and care to improve health in resource-limited, rural communities,” said Tim Mercer, MD, MPH, chief of the division of global health at Dell Medical School at The University of Texas at Austin. “It tackles the global challenge of diabetes and related NCDs through sustainable strategies that strengthen the healthcare system and build trust with the community.”
Dell Medical School and Benemérita Universidad Autónoma de Puebla (BUAP) Faculty of Medicine in Puebla are the lead partners for the AMPATH (Academic Model Providing Access to Healthcare)/MAPAS (Modelo Académico para Proveer Acceso a la Salud) México partnership.
Specific objectives of the program are to:
Train and deploy a primary health care workforce of community health volunteers (promotoras comunitarias) and recent medical school graduates completing their year of social service (pasantes) while also mentoring existing primary care center staff to collectively address diabetes and related NCDs.
Screen for diabetes and its related NCDs including obesity, hypertension, and cardiovascular risk, via comprehensive household and community-based screening and health promotion activities.
Implement a model of group-based diabetes and related NCD care that combines health promotion and peer support with disease management while addressing social drivers of health.
The initial community health needs assessment conducted in Puebla revealed that diabetes and access to quality health care and medications were the two dominant health-related concerns of community members. Puebla state-level data show that diabetes is the leading cause of death and disability along with ischemic heart disease and chronic kidney disease, both consequences of poorly controlled diabetes.
"AMPATH is not just a healthcare impact project,” said Luis Guillermo Vázquez de Lara Cisneros, MD, PhD, dean of the BUAP Faculty of Medicine. “It is an academic model that not only transforms the communities where it operates, but also evaluates its outcomes and enables scalable implementation in other settings."
The program will initially begin in the three resource-limited communities of Colonia Agrarista, San Francisco Xochiteopan, and Santa Ana Coatapec with plans to add two additional resource-limited communities with amplified program reach through the main public medical school in Puebla. The goal is for health workers trained through the program to reach 400,000 people over the next three years.
“This program has the potential to improve the lives of individuals and build capacity within the healthcare system in resource-limited communities in Puebla, Mexico. It builds on Lilly’s long-term support towards Indiana University, who in turn supports AMPATH’s efforts around the world as they tackle some of the world’s more complex health challenges,” said Cynthia Cardona, Lilly’s vice president of Social Impact.
The impact of the AMPATH/MAPAS México diabetes and NCD program will be evaluated through direct monitoring and outcome measurements. Increased data management and analysis capacity will enable AMPATH/MAPAS to conduct rigorous interdisciplinary research needed to inform, implement, adapt, and improve their model of community-based care.