ArticleBJGP open2018
Process evaluation of integrated diabetes management at primary healthcare facilities in Pakistan: a mixed-methods study.
Article in BJGP open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Implementation strategies for evidence-based management of type 2 diabetes at primary healthcare facilities in low- and middle-income countries and related barriers and facilitators: a scoping review.Implementation science communications · 2026Pooled it
- A Scoping Review of Noncommunicable Disease Programs Evaluation: Bridging Gaps and Improving Frameworks in Primary Healthcare.Health science reports · 2026Review
- Delivering non-communicable disease services through primary health care in selected south Asian countries: are health systems prepared?The Lancet. Global health · 2024Review
- Article
- mHealth guideline training for non-communicable diseases in primary care facilities in Nigeria: a mixed methods pilot study.BMJ open · 2022Article
- Adapting and implementing training, guidelines and treatment cards to improve primary care-based hypertension and diabetes management in a fragile context: results of a feasibility study in Sierra Leone.BMC public health · 2020Article
- Decentralising NCD management in rural southern Africa: evaluation of a pilot implementation study.BMC public health · 2020Article
- Article
- Effectiveness of an integrated diabetes care package at primary healthcare facilities: a cluster randomised trial in Pakistan.BJGP open · 2018Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIntegrated care for diabetes and associated conditions at primary level health facilities can make care available to a much larger population, especially in rural areas.
aimThis process evaluation was to understand how the authors' integrated care was implemented and experienced by the care providers and patients, and to inform modifications prior to province-wide scale-up. DESIGN &
settingThe mixed-method study was conducted as part of a cluster randomised trial on integrated diabetes care at 14 public health facilities.
methodThe care practices were assessed by analysing the routine clinical records of 495 registered patients with diabetes. Then semi-structured interviews with service providers and patients were used to understand their respective care experiences. A framework approach was applied to analyse and interpret the qualitative data.
resultsThe intervention and the study were implemented as intended under routine conditions in rural health centres. Key service processes effectively delivered included: skill-based training; screening and diagnostic tests; treatment card records; and the additional case management as per desk guide, including monitoring progress in glucose and weight at follow-up consultations, and mobile phone calls to help adherence. However, social and cultural factors affected clients' ability to change lifestyles, especially for women. The intervention effect was limited by the short study follow-up of only 9 months.
conclusionIntegrated diabetes care was feasible, both for providers and patients, and potentially scalable at primary care facilities under routine conditions in Pakistan. Additional operational interventions are required for sustained drug supplies, supervision, in-service training, and to address the social challenges to healthy activity and eating, especially for women.
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