Table 4.
Availability of supplies and equipment for diabetes care by facility level
| ICCCa requirement | Operationalization of ICCC description | Findings by facility level | |||
|---|---|---|---|---|---|
| Medical equipment and supplies | List recommended by IDAb guidelines | Referral hospital | District hospital | Health centre | Dispensary |
| Urine strips for glucose, ketones and proteins | A and Fc | A and F | None | None | |
| Blood glucose meter | A and F | A and F | None | None | |
| Appropriate glucose strips | A and F | A and F | None | None | |
| Sphygmomanometer | A and F | A and F | A and F | A and F | |
| Cuff sizes for sphygmomanometer | One size | One size | One size | One size | |
| Weight scale | A and F | A and F | A and F | A and F | |
| Height scale | A and F | None | None | None | |
| Monofilament | None | None | None | None | |
| Prescribed for secondary-level facilities and first-level referral facilities | |||||
| Tuning fork and patellar hammer | None | None | Not expected at health centre level | Not expected at dispensary | |
| Ophthalmoscope | A and F | None | |||
| Biochemistry analyzer: | |||||
| • Glucose | None | None | |||
| • Lipids | None | None | |||
| • Renal functions | A and F | A and NFd | |||
| • Glycated hemoglobin | None | None | |||
| Laboratory | Laboratory services | A and F | A and F | A and NF | None |
| Essential medications for diabetes | List recommended by STGe | ||||
| Chlorpropamide | None | None | None | None | |
| Glibenclamide | Available | Available | None | None | |
| Gliclazide | None | None | None | None | |
| Tolbutamide | None | None | None | None | |
| Metformin | None | None | None | None | |
| Glucagon injection | None | None | Not expected at health centres | Not expected at dispensary level | |
| Insulin short acting | Available | None | |||
| Insulin intermediate acting | None | None | |||
| Insulin long acting | Available | None | |||
| Decision-making | Guidelines/algorithms | None | None | None | None |
a
Innovative care for chronic conditions.
b
International Diabetes Association, Africa (2006). Type 2 Diabetes Clinical Guidelines for SSA.
c
A and F—Available and functional.
d
A and NF - Available and not functional.
e
STG—Ministry of Health, Tanzania (2007). Standard Treatment Guidelines.