E-health initiatives for screening and management of diabetes in rural Rajasthan

Mobile or electronic health technology (e-health) initiatives are being employed in various health programmes for disease monitoring. Very few such studies have been conducted in India and other developing countries. We planned this study to assess the feasibility and usefulness of e-health intervention for health workers as accredited social health activist (ASHA) in screening and management of diabetes. We developed a web-based application for use on a portable device (tablet) to screen and diagnose non-communicable diseases like diabetes, provide health education focused on diet and physical exercise and promote adherence to therapies. ASHA workers were recruited in two villages of Rajasthan and trained to use this technology. With the use of e-health initiatives, among populations above 18 years, we found 1.19% (29/2430) diabetics, 44.82% (13/29) newly detected and 2.84% (69/2430) prediabetics. The prevalence of prediabetes decreased over a period of time in the population under follow-up. Also, could start 37.93% diabetics on treatment due to constant follow-up, referral and monthly specialist visits to the village. Training ASHA worker in e-health is feasible and can assist in screening for diseases. This technology facilitates lifestyle and diet modifications and leads to better adherence to therapies by repeated sessions of one-to-one health education. In our study area, we found low levels of diabetes and prediabetics, which can be due to low waist circumference, low BMI and W/H ratio and high MET.