Process Evaluation of the Diabetes Mellitus Management Program at Primary Healthcare Facilities in Thiruvananthapuram, Kerala, India, 2021
Abstract
BACKGROUND: Kerala, a state in southern India with a 21% prevalence of diabetes mellitus (DM), has implemented a DM management program since 2011.
OBJECTIVES: This study evaluated the DM management program in the Thiruvananthapuram district of Kerala to assess if it was operating as intended and identify improvement opportunities.
MATERIALS AND METHODS: We conducted a cross-sectional survey in 11 public primary care facilities between April and August 2021. The study documented the availability of various resources in the health facilities using a data abstraction form. We interviewed 125 healthcare providers and 504 patients using a semi-structured questionnaire. We analyzed the input, process, and output indicators as proportions and estimated the proportion of registered DM patients under glycemic control with a 95% confidence interval (CI).
RESULTS: Screening registers were not updated in eight facilities, but nine out of 11 had updated treatment registers. Nearly two-fifths of the medical officers were trained in DM management. Metformin and glimepiride were stocked for at least 2 months in six out of 11 facilities. Almost four-fifths of all registered patients were treated and followed up appropriately at least once a month. Of 504 patients, 165 (33%; 95% CI, 29-37) had blood sugar under control.
CONCLUSION: The evaluation found training, documentation on screening, and adequacy of drug stocks as key areas for improvement in the program. Despite follow-up, most DM…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 504 participants or records.
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