This study sought to build understanding of the pathways for referral and treatment of DM/DR and the organisation of service delivery at three large tertiary hospitals in Pakistan. It also explored the factors enabling or hindering adherence to referrals and treatment follow-up in these settings. The study has a number of programme implications regarding training and support systems for LHWs, the nature and role of counselling; and the approaches needed to enhance women’s access to DM/DR services.
The results of this study also call for finding models of care, which are responsive to the needs of diabetes patients, i.e. delivered through smaller and less overburdened facilities, closer to patients’ home and with more convenient opening times.