スギシタ　トモヒコ   Sugishita Tomohiko   杉下　智彦    所属   医学部 医学科    職種   非常勤講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Analyzing the Implementation of Policies and Guidelines for the Prevention and Management of Type 2 Diabetes at Primary Health Care Level in Nepal.
掲載誌名	正式名：Frontiers in public health 略　 称：Front Public Health ISSNコード：22962565/22962565
掲載区分	国外
巻・号・頁	10,pp.763784
国際共著	国際共著
著者・共著者	Shrestha Rabina†, Yadav Uday Narayan, Shrestha Abha, Paudel Grish, Makaju Deepa, Poudel Prakash, Iwashita Hanako, Harada Yuriko, Shrestha Archana, Karmacharya Biraj, Koju Rajendra, Sugishita Tomohiko, Rawal Lal*
発行年月	2022
概要	BACKGROUND:Nepal, in recent years, is witnessing an increasing problem of type 2 diabetes that has resulted significant premature deaths and disability. Prevention and management of non-communicable diseases (NCDs) including diabetes have been prioritized in the national policies and guidelines of the Nepal Government. However, research looking at the overview of the implementation of the existing policies and guidelines for diabetes prevention and control is scarce. Hence, this study reviewed diabetes related existing policies and its implementation process at the primary health care level in Nepal.METHODS:This study involved two phases: Phase I: situation analyses through review of documents and Phase II: qualitative exploratory study. In phase I, four databases (Medline, Web of Science, Embase and PubMed) were systematically searched using key search terms related to diabetes care and policies between January 2000 and June 2021. Also, relevant gray literature was reviewed to understand the trajectory of policy development and its translation with regards to diabetes prevention and management at primary health care level in Nepal. Following the phase I, we conducted in-depth interviews (IDI) and key informant interviews (KII) with health care providers, policy makers, and managers (IDI = 13, and KII = 7) at peripheral and central levels in Kavrepalanchowk and Nuwakot districts of Nepal. The in-depth interviews were audio recorded, transcribed, and coded. The triangulation of data from document review and interviews was done and presented in themes.RESULTS:Four key themes were identified through triangulating findings from the document review and interviews including (i) limited implementation of policies into practices; (ii) lack of coordination among the different levels of service providers; (iii) lack of trained human resources for health and inadequate quality services at the primary health care level, and (iv) inadequate access and utilization of diabetes car
DOI	10.3389/fpubh.2022.763784
PMID	35223722