title: Eye care infrastructure and human resources for managing diabetic retinopathy in India: The India 11-city 9-state study.
abstract: BACKGROUND
  There is a paucity of information on the availability of services for diagnosis and management of diabetic retinopathy (DR) in India.
  
  
  OBJECTIVE
  The study was undertaken to document existing healthcare infrastructure and practice patterns for managing DR.
  
  
  METHODS
  This cross-sectional study was conducted in 11 cities and included public and private eye care providers. Both multispecialty and stand-alone eye care facilities were included. Information was collected on the processes used in all steps of the program, from how diabetics were identified for screening through to policies about follow-up after treatment by administering a semistructured questionnaire and by using observational checklists.
  
  
  RESULTS
  A total of 86 eye units were included (31.4% multispecialty hospitals; 68.6% stand-alone clinics). The availability of a dedicated retina unit was reported by 68.6% (59) facilities. The mean number of outpatient consultations per year was 45,909 per responding facility, with nearly half being new registrations. A mean of 631 persons with sight-threatening-DR (ST-DR) were registered per year per facility. The commonest treatment for ST-DR was laser photocoagulation. Only 58% of the facilities reported having a full-time retina specialist on their rolls. More than half the eye care facilities (47; 54.6%) reported that their ophthalmologists would like further training in retina. Half (51.6%) of the facilities stated that they needed laser or surgical equipment. About 46.5% of the hospitals had a system to track patients needing treatment or for follow-up.
  
  
  CONCLUSIONS
  The study highlighted existing gaps in service provision at eye care facilities in India.
authors.affiliation: Department of Clinical Research, International Centre for Eye Health, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Clare E
authors.initials: CE
authors.lastname: Gilbert
authors.affiliation: South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India.
authors.forename: R Giridhara
authors.initials: RG
authors.lastname: Babu
authors.affiliation: South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India.
authors.forename: Aashrai Sai Venkat
authors.initials: AS
authors.lastname: Gudlavalleti
authors.affiliation: South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India.
authors.forename: Raghupathy
authors.initials: R
authors.lastname: Anchala
authors.affiliation: South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India.
authors.forename: Rajan
authors.initials: R
authors.lastname: Shukla
authors.affiliation: South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India.
authors.forename: Pant Hira
authors.initials: PH
authors.lastname: Ballabh
authors.affiliation: Department of Community Ophthalmology, Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Praveen
authors.initials: P
authors.lastname: Vashist
authors.affiliation: South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India.
authors.forename: Srikrishna S
authors.initials: SS
authors.lastname: Ramachandra
authors.affiliation: South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India.
authors.forename: Komal
authors.initials: K
authors.lastname: Allagh
authors.affiliation: South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India.
authors.forename: Jayanti
authors.initials: J
authors.lastname: Sagar
authors.affiliation: South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India.
authors.forename: Souvik
authors.initials: S
authors.lastname: Bandyopadhyay
authors.affiliation: Department of Clinical Research, International Centre for Eye Health, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK; South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India.
authors.forename: G V S
authors.initials: GV
authors.lastname: Murthy
keywords: Diabetes complications; India; diabetic retinopathy; diagnostic equipment; health facilities; human resources