A design



Evaluation of diabetes care management in primary clinics based on the guidelines of American Diabetes Association

Albarrak, Mohammed [19]

The main objective of this study was to assess diabetes care in primary clinics based on the guidelines of American Diabetes

Association (ADA).

A retrospective study at King Khaled University Hospitals


Saudi Arabia.

The result showed that elements achieving the ADA targets for overall care were medical history (44.9%), physical examination (59.6%), laboratorye valuation (36.3%), and referrals (19.3%). The other subelement indicators such asreferral to diabetes self-management education clinics (10%), dental examination (2%), HbA1c regular monitoring (33.5%), and blood pressure

determination (100%) were documented with adherence to ADA standards.

Public health facility resource availability and provider adherence to first antenatal guidelines in a low resource setting in Accra, Ghana

Amoakoh-Coleman, Agyepong [14]

aim was to describe public health facility resource availability in relation to provider adherence to first antenatal visit guidelines.

A cross-sectional analysis of the baseline data of a prospective cohort study was carried out in 11 facilities in the Greater Accra Region of Ghana.


Eleven facilities comprising 6 hospitals (54.5%), 4 polyclinics (36.4%) and 1 health center were randomly sampled. Complete provider adherence to first antenatal guidelines for all the 946 participants was 48.1% varying significantly amongst the types of facilities, with highest rate in the polyclinics.

Client Factors Affect Provider Adherence to Clinical Guidelines during First Antenatal Care

Amoakoh-Coleman, Agyepong [2]

Our objectives were to determine the level of provider adherence to first antenatal visit guidelines in the Safe Motherhood Protocol (SMP), and assess patient factors that determine complete provider adherence.

Cross-sectional study is part of a cohort study that recruited women who delivered in eleven health facilities and who had utilized antenatal care services during their pregnancy in the Greater Accra region of Ghana


Complete adherence to guidelines pertained to only 48.1% of pregnant women. Providers were significantly more likely to completely adhere to guidelines when caring for multiparous women but less likely to do so when attending to women with history of previous pregnancy complications

Knowledge and practice related to gestational diabetes among primary health care providers in Morocco: Potential for a defragmentation of care?

Utz, Assarag [20]

The objective of this study was to assess knowledge and practices of general practitioners, nurses and midwives working at primary health care facilities in Morocco regarding screening and management of gestational diabetes (GDM).

Structured interviews with 100 doctors, midwives and nurses at 44 randomly Selected public health Care centers were conducted in Marrakech and Al Haouz. All data Were descriptively analyzed.


Public primary health care providers have a basic understanding of gestational diabetes but screening and management practices are not uniform. Although 56.8% of the Doctors had some pre-service training on gestational diabetes, most nurses and midwives

lack such training

“Why screen if we cannot follow-up and manage?” Challenges for gestational diabetes screening and management in low and lower-middle income countries: results of a cross-sectional survey

Utz and De Brouwere [10]

The objective of our study was to identify the challenges that first line healthcare providers in LLMIC face in screening and management of GDM.

We conducted a cross-sectional survey of key informants from 40 low and lower-middle income by sending out questionnaires to 182 gynecologists, endocrinologists and medical doctors

Africa, South-Asia and Latin-America

Unavailability of guidelines combined with lack of knowledge about GDM on the part of both providers and patients poses a substantial barrier to detection and management of GDM, leading to deficiencies in screening and counseling.

Detection and Management of Diabetes during Pregnancy in Low Resource Settings: Insights into Past and Present Clinical Practices

Utz, Delamou [12]

To identify modalities of gestational diabetes detection and management in low and lower middle income countries.

a scoping review was conducted of published literature and searched the databases all articles published until April 24, 2016 included.

Asia and sub-Saharan Africa.

23 articles were identified mainly from Asia and sub-Saharan Africa. The majority of studies were conducted in large tertiary care centers and hospital admission was reported in a third of publications.