title: Strengthening diabetes retinopathy services in India: Qualitative insights into providers' perspectives: The India 11-city 9-state study.
abstract: BACKGROUND
  There is a lack of evidence on the subjective aspects of the provider perspective regarding diabetes and its complications in India.
  
  
  OBJECTIVE
  The study was undertaken to understand the providers' perspective on the delivery of health services for diabetes and its complications, specifically the eye complications in India.
  
  
  METHODS
  Hospitals providing diabetic services in government and private sectors were selected in 11 of the largest cities in India, based on geographical distribution and size.
  
  
  METHODS
  Fifty-nine semi-structured interviews conducted with physicians providing diabetes care were analyzed all interviews were recorded, transcribed, and translated. Nvivo 10 software was used to code the transcripts. Thematic analysis was conducted to analyze the data.
  
  
  RESULTS
  The results are presented as key themes: "Challenges in managing diabetes patients," "Current patient management practices," and "Strengthening diabetic retinopathy (DR) services at the health systems level." Diabetes affects people early across the social classes. Self-management was identified as an important prerequisite in controlling diabetes and its complications. Awareness level of hospital staff on DR was low. Advances in medical technology have an important role in effective management of DR. A team approach is required to provide comprehensive diabetic care.
  
  
  CONCLUSIONS
  Sight-threatening DR is an impending public health challenge that needs a concerted effort to tackle it. A streamlined, multi-dimensional approach where all the stakeholders cooperate is important to strengthening services dealing with DR in the existing health care setup.
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, Hyderabad, Telangana, India.
authors.forename: Nanda Kishore
authors.initials: NK
authors.lastname: Kannuri
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, 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, Hyderabad, Telangana, India; Department of Clinical Research, Faculty of Infectious and Tropical Diseases, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Gudlavalleti V S
authors.initials: GV
authors.lastname: Murthy
authors.affiliation: Department of Clinical Research, Faculty of Infectious and Tropical Diseases, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Clare E
authors.initials: CE
authors.lastname: Gilbert
keywords: Diabetes; India; diabetes retinopathy; health system response; providers perspective