Goal –

To demonstrate the applicability of a sustainable health promotion model in order to advocate it as a nationally relevant model for prevention of diabetes mellitus and CVD through community based interventions in vulnerable populations, based on the lessons learnt in the inaugural NIROGI Lanka project component 3

Objectives –

1. To demonstrate the impact of the health promotion model established in the NIROGI Lanka project for prevention of diabetes mellitus and CVD

2. To establish the sustainability of the NIROGI Lanka health promotion model in the already established settings in Kotte and Kolonnawa

3. Based on the lessons learnt, to initiate the NIROGI Lanka health promotion model in different settings amongst the most vulnerable groups of people through capacity building of them as health promotion facilitators, providing a supportive environment to change and monitoring and evaluation of their achievements

4. To maintain the health data / information management system from family to entire community

Expected outcomes –

To advocate a nationally relevant sustainable model for Health Promotion in the prevention of diabetes and CVD in Sri Lanka


Project areas –

• Kotte and Kolonnawa Medical Officer of Health (MOH) areas located in suburban areas. These settings have been already established in the inaugural NIROGI Lanka project.

• Metropolitan area of the district of Colombo that represents the most urbanised areas in Sri Lanka.

• Piliyandala MOH area that represents a relatively rural community.

Target groups –

• Communities living in the urban, suburban and rural sectors in the district of Colombo.
• Work places with more than 1000 workers in the Metropolitan area in the district of Colombo
• National, Non-national and International schools located in the Metropolitan area in the district of Colombo

Project activities –

1. To demonstrate the impact of the health promotion model established in the NIROGI Lanka project for prevention of diabetes mellitus and CVD

1.1. To evaluate the health promotion process and medium/long term outcomes in the already established settings in Kotte and Kolonnawa.

Process used and the medium/long term outcomes of the model will be evaluated through an independent review process using the behavioural indicators developed by the Ministry of Health. These indicators are related to diet, physical activities, tobacco, alcohol and mental stress and will be further modified following in-depth interviews and focus group discussions with the relevant stake holders.

1.2. To develop an advocacy package to motivate policy makers in making healthy policies.

An advocacy package that focuses on addressing the underlying behavioural risk factors of diabetes and CVD at area level and the support expected from them will be developed. Policy makers will be encouraged to provide a supportive physical environment for people to have healthy behaviour.

2. To establish the sustainability of the NIROGI Lanka health promotion model in the already established settings in Kotte and Kolonnawa

2.1. To further establish fully autonomous settings without central supervision

2.2. To establish a supportive environment for people to develop healthy behaviour through social mobilisation and inter-sectoral collaboration

Periodic reviews of the established settings will be carried out with the participation of relevant stake holders to solicit the support of other sectors. Home gardening, foot paths for walking, no-tobacco boutiques/shops, healthy food outlets, community exercise programmes, etc will be established through social mobilisation and inter-sectoral collaboration.

3. Based on the lessons learnt, to establish the NIROGI Lanka health promotion model in different settings amongst the most vulnerable groups of people through capacity building of the vulnerable groups as Health Promotion Facilitators (HPF), providing a supportive environment to change and monitoring and evaluation of their progress





Research evidence suggests that urbanization and its ensuing sedentary lifestyle play a key role in the accumulation of risk factors of diabetes. In view of this, school children, adolescents and working population of middle and upper income class living/working in Metropolitan areas of Colombo representing the most urbanised areas of Sri Lanka are identified as the target groups for health promotion as they are the most prone to unhealthy food habits related to fibre and trans fats, less physical activities related to occupation/school, transport and recreation, stressful work/school environment and substance use.

Three settings and target groups are identified for health promotion:

3.1 To initiate ‘healthy worker settings’ using productivity enhancement approach

Five work settings in the Metropolitan area of Colombo with more than 1000 workers per setting will be selected for this project. Employees of different strata including executive and managerial levels will be targeted in this activity. Initially, 20 employees from each setting will undergo capacity building in health promotion as Health Promotion Facilitators (HPF) and another 30 at later stages. Identification and motivation of these HPF in health promotional work will be done via already existing systems in institutions such as productivity enhancement workshops that target employees. Health promotional activities too will be introduced through the same productivity enhancement approach. Advocacy programmes at managerial level will address issues related to supportive environments within work settings. This project envisages to train 250 employees as HPF (primary target group) and thereby about 5,000 employees in HP (secondary target group).

3.2 To initiate a cohort of school children as ‘health messengers’ for school and family based health promotion in collaboration with the Ministry of Education

Five secondary schools with more than 1000 students each will be selected from Government (2 schools), Private (2 schools) and International (1 school) schools in Colombo Municipal Council areas. This project intends to train school children as ‘health messengers’ and to incorporate the life-cycle approach of NCD into the school curriculum and assessments in collaboration with the Ministry of Education. This project envisages to train initially about 125 school children from the five schools and later up to 2000 school children as ‘health messengers’ (primary target group) and 10,000 family members of students (secondary target group).

3.3 To initiate new settings in a relatively rural community (Piliyandala)

Through further capacity building of participants of the project as HPF, 10 new settings will be established in a relatively rural community. This project envisages training initially 10 community participants as HPF and later up to 200 HPF (primary target group) and thereby about 1000 family members (secondary target group).

4. To maintain the health data / information management system from family to Division

4.1 A cohort of families in the Kotte MOH area (3 public health midwife areas consisting of about 3000 population in each)

4.2 A cohort of high risk population (1000 adults employed in sedentary settings)

4.3 To establish a cohort of 300 post-partum women with gestational diabetes in Dompe to evaluate the change in behaviour and outcomes in integration with the NIROGI Maatha
Participants of the above settings will be followed up to monitor and update the risk factors of diabetes and CVD for long term management via the already established Health Information System (HIS) of the NIROGI Lanka project. In all three databases, fasting plasma glucose and behaviour-related risk factors will be assessed at baseline and thereafter periodically.