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Diabetic retinopathy service delivery and integration into the health system in Pakistan—Findings from a multicentre qualitative study
- Source :
- PLoS ONE, PLoS ONE, Vol 16, Iss 12, p e0260936 (2021)
- Publication Year :
- 2021
- Publisher :
- Public Library of Science, 2021.
-
Abstract
- This paper is based on qualitative research carried out in a diabetic retinopathy (DR) programme in three districts of Pakistan. It analyses the organisation and delivery of DR services and the extent to which the interventions resulted in a fully functioning integrated approach to DR care and treatment. Between January and April 2019, we conducted 14 focus group discussions and 37 in-depth interviews with 144 purposively selected participants: patients, lady health workers (LHWs) and health professionals. Findings suggest that integration of services was helpful in the prevention and management of DR. Through the efforts of LHWs and general practitioners, diabetic patients in the community became aware of the eye health issues related to uncontrolled diabetes. However, a number of systemic pressure points in the continuum of care seem to have limited the impact of the integration. Some components of the intervention, such as a patient tracking system and reinforced interdepartmental links, show great promise and need to be sustained. The results of this study point to the need for action to ensure inclusion of DR on the list of local health departments’ priority conditions, greater provision of closer-to-community services, such as mobile clinics. Future interventions will need to consider the complexity of adding diabetic retinopathy to an already heavy workload for the LHWs.
- Subjects :
- Adult
Male
Patients
Endocrine Disorders
Economics
Science
Health Care Providers
Health Personnel
Social Sciences
Surgical and Invasive Medical Procedures
Endocrinology
Medical Conditions
Ocular System
Physicians
Medicine and Health Sciences
Diabetes Mellitus
Humans
Pakistan
Medical Personnel
Qualitative Research
Aged
Multidisciplinary
Diabetic Retinopathy
Delivery of Health Care, Integrated
Biology and Life Sciences
Focus Groups
Middle Aged
Health Care
Professions
Health Care Facilities
Metabolic Disorders
People and Places
Medicine
Eyes
Population Groupings
Female
Anatomy
Head
Finance
Research Article
Women, Working
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 16
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....306c764dd44d50385b6eb8f3347c82db