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 patients had poor glycemic control. The study recommends conducting training of medical officers, strengthening the reporting and registration of screening activities, and improving the minimal drug stocks.
Jaya et al. (Thu,) studied this question.
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