Table 4 Simplification process of SOPs for the diagnosis of DM
| Â | 2016 | 2017 | 2018 | 2019 |
|---|---|---|---|---|
Diagnostic approach At site level | No diagnostic devices used at site level | FBS/RBS on hand-held glucometer | FBS/RBS on hand-held glucometer | FBS/RBS on hand-held glucometer And HbA1c on Point of care platform to confirm |
Conventional laboratory (hospital based) | Lab-based FBG | Confirm with lab-based FBG | Not applicable | Not applicable |
Lab-based HbA1c to confirm | Lab-based HbA1c for final diagnosis | Lab-based A1c to confirm | Not applicable | |
Rationale | Dependency on sample transport (ST) and stability Lab overwhelmed Delays in result reception | Same dependency on ST Lab workload improved Still delays in result reception | Same dependency on ST Lab workload improved. Still delays in result reception Need for motivated HR to follow quality control procedures for HbA1c | Increased autonomy at PHC Faster decision making |