Diabetic retinopathy service delivery and integration into the health system in Pakistan: findings from a multicentre qualitative study
Summary
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.
Findings suggest that integration of services was helpful in the prevention and management of DR. Through the efforts of Lady Health Workers 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.
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, as well as greater provision of closer-to-community services, such as mobile clinics.