Health system performance for people with diabetes in 28 low- and middle-income countries: A cross-sectional study of nationally representative surveys

Jennifer Manne-Goehler, Pascal Geldsetzer, Kokou Agoudavi, Glennis Andall-Brereton, Krishna K Aryal, Brice Wilfried Bicaba, Pascal Bovet, Garry Brian, Maria Dorobantu, Gladwell Gathecha, Mongal Singh Gurung, David Guwatudde, Mohamed Msaidie, Corine Houehanou, Dismand Houinato, Jutta Mari Adelin Jorgensen, Gibson B Kagaruki, Khem B Karki, Demetre Labadarios, Joao S Martins, Mary T Mayige, Roy Wong McClure, Omar Mwalim, Joseph Kibachio Mwangi, Bolormaa Norov, Sarah Quesnel-Crooks, Bahendeka K Silver, Lela Sturua, Lindiwe Tsabedze, Chea Stanford Wesseh, Andrew Stokes, Maja Marcus, Cara Ebert, Justine I Davies, Sebastian Vollmer, Rifat Atun, Till W Bärnighausen and Lindsay M Jaacks

PLOS Medicine, 2019, vol. 16, issue 3, 1-21

Abstract: Background: The prevalence of diabetes is increasing rapidly in low- and middle-income countries (LMICs), urgently requiring detailed evidence to guide the response of health systems to this epidemic. In an effort to understand at what step in the diabetes care continuum individuals are lost to care, and how this varies between countries and population groups, this study examined health system performance for diabetes among adults in 28 LMICs using a cascade of care approach. Methods and findings: We pooled individual participant data from nationally representative surveys done between 2008 and 2016 in 28 LMICs. Diabetes was defined as fasting plasma glucose ≥ 7.0 mmol/l (126 mg/dl), random plasma glucose ≥ 11.1 mmol/l (200 mg/dl), HbA1c ≥ 6.5%, or reporting to be taking medication for diabetes. Stages of the care cascade were as follows: tested, diagnosed, lifestyle advice and/or medication given (“treated”), and controlled (HbA1c

Date: 2019
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pmed00:1002751

DOI: 10.1371/journal.pmed.1002751

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