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. 2018 Dec 27;18(1):97.
doi: 10.1186/s12902-018-0324-5.

Retrospective assessment of the quality of diabetes care in a rural diabetes clinic in Western Kenya

Sonak D Pastakia  1   2   3   4 , Bernardo Nuche-Berenguer  5 , Chelsea Regina Pekny  6 , Benson Njuguna  7 , Elizabeth Guinevere O'Hara  8 , Stephanie Y Cheng  9 , Jeremiah Laktabai  10   7   11 , Victor Buckwalter  11 , Nicholas Kirui  7 , Patrick Chege  10   11
Affiliations

Retrospective assessment of the quality of diabetes care in a rural diabetes clinic in Western Kenya

Sonak D Pastakia et al. BMC Endocr Disord. .

Abstract

Background: Sub-Saharan Africa continues to face the highest rate of mortality from diabetes in the world due to limited access to quality diabetes care. We assessed the quality of diabetes care in a rural diabetes clinic in western Kenya.

Methods: To provide a comprehensive assessment, a set of clinical outcomes, process, and structure metrics were evaluated to assess the quality of diabetes care provided in the outpatient clinic at Webuye District Hospital. The primary clinical outcome measures were the change in HbA1c and point of care blood glucose. In assessing process metrics, the primary measure was the percentage of patients who were lost to follow up. The structure metrics were assessed by evaluating different facets of the operation of the clinic and their accordance with the International Diabetes Federation (IDF) guidelines.

Results: A total of 524 patients were enrolled into the diabetes clinic during the predefined period of evaluation. The overall clinic population demonstrated a statistically significant reduction in HbA1c and point of care blood glucose at all time points of evaluation after baseline. Patients had a mean baseline HbA1C of 10.2% which decreased to 8.4% amongst the patients who remained in care after 18 months. In terms of process measures, 38 patients (7.3%) were characterized as being lost to follow up as they missed clinic visits for more than 6 months. Through the assessment of structural metrics, the clinic met at least the minimal standards of care for 14 out of the 19 domains recommended by the IDF.

Conclusion: This analysis illustrates the gains made in various elements of diabetes care quality which can be used by other programs to guide diabetes care scale up across the region.

Keywords: Diabetes; Diabetes care; Non-communicable disease; Rural; Sub-saharan Africa.

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Conflict of interest statement

Ethical approval and consent to participate

This study was approved by the Moi Teaching and Referral Hospital/Moi University School of Medicine Institutional Research and Ethics Committee and the Institutional Review Board of the Indiana University Purdue University Indianapolis (IUPUI). A waiver of informed consent was obtained from both of the institutions as all data being assessed was collected through routine clinical care and was de-identified before being retrospectively assessed.

Consent for publication

Not applicable.

Competing interests

Sonak Pastakia serves as a consultant for Abbott on work unrelated to the study being presented here. The other authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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