Evaluation of Performance of Diabetes Care Initiatives implemented in Cambodia

Increase of type 2 diabetes mellitus (T2DM) prevalence in low-and middle-income countries including Cambodia have been significantly observed. However, diabetes care provided is not prompt and adequate. In Cambodia, three main diabetes care initiatives with different care approaches (hospitalbased care, health centre-based care, and community-based care) are prioritised in 2013-2020 national strategic plan and on scale up process. They are being implemented in isolation with relatively little linkage or interaction with each other, and empirical studies on their performance are quite limited. Therefore, this proposed study will evaluate their performance for provision of diabetes care to population with T2DM in Cambodia. Implementation outcomes (Acceptability, Appropriateness, Feasibility, Coverage, Fidelity, Implementation cost, Adoption, and Sustainability) will be used as performance indicators. The Innovative Care for Chronic Conditions framework will be utilised as an analytical framework to review and assess the care initiatives, combined with use of diabetes cascadeof-care, adapted from HIV cascade-of-care, as outcome measurement. We will examine contextual factors, patients’ knowledge and behaviour, utilisation of health services, and self-care practices in relation to the care initiatives. Cost of service provision and cost burden to patients as well as policy response to the burden of T2DM and care initiatives will also be explored.