TOMOHIKO SUGISHITA
   Department   School of Medicine, School of Medicine
   Position  
Article types Original article
Language English
Peer review Peer reviewed
Title Analyzing the Implementation of Policies and Guidelines for the Prevention and Management of Type 2 Diabetes at Primary Health Care Level in Nepal.
Journal Formal name:Frontiers in public health
Abbreviation:Front Public Health
ISSN code:22962565/22962565
Domestic / ForeginForegin
Volume, Issue, Page 10,pp.763784
International coauthorship International coauthorship
Author and coauthor 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*
Publication date 2022
Summary 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