Health System Analysis of Diabetes and Diabetic Retinopathy Services in Nigeria – The Case of Akwa Ibom State

Master Thesis


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This research project, undertaken for a MPH dissertation investigated and analysed the situation of diabetes and diabetic retinopathy services and management systems in four (4) government hospitals in Akwa Ibom State Nigeria using the World Health Organisation (WHO) Tool for the Assessment of Diabetic Retinopathy and Diabetes Management Systems (TADDS). Part A is the research protocol, which explains the background and the key components of this research study. This is a cross sectional descriptive case study involving primary data collection. We conducted the case study using the WHO TADDS to survey health personnel involved in the management of diabetes mellitus (DM) and diabetic retinopathy (DR) in four (4) government hospitals in Akwa Ibom State. Concurrently, semi-structured interviews were conducted with key informants to investigate and analyse the situation of DM and DR services in Akwa Ibom State in Nigeria. Part B is a structured literature review of published articles, online reports, and summaries related to DR. It covers the review of scientific evidence (clinical overview) about the aetiology and prevention of DR and the known risk factors; the review of epidemiological evidence on DM and DR globally and in sub-Saharan Africa (SSA); and the review of the evidence on effectiveness and cost-effectiveness of public health and health system interventions for the prevention and management of DR. Part C is the journal-ready manuscript. In this part, the format of the journal Ophthalmic Epidemiology was used to present the research project and its main findings. Part D contains all the relevant appendices used during the research project.