Data Analysis of Evidence Based Diabetes Management Capacity Building Programs for Primary Care Physicians (PCPs) in India
Singh, Amit*1, Choudhry, Santosh1, Kumar, Santosh1, Mehra, Rakesh1, Jose, Arun1, Kumar, Pushkar1, Bhalla, Sandeep1
1 Public Health Foundation of India, New Delhi, India
* Email ID: amit.kumar2@phfi.org
Background: Diabetes is one of the largest global health emergencies of the 21st Century in Non-Communicable Diseases (NCDs). Diabetes ranks fourth among NCDs in terms of mortality caused. India with no exception is home to 69.2 million diabetes people and prediction indicates that it will increase to 123.1 million by 2040. This combined with the low doctor population ratio (1:2000) makes it exceedingly essential to make aware and strengthen the skills of primary care physicians (PCPs) to recognize the triggering factors for Diabetes appropriately and comprehensively. In 2010, a comprehensive capacity building program was launched by PHFI in association DMDEA with an objective to develop the skills and core competencies of PCPs to address the case management and to establish the referral linkage patterns for timely diagnosis and swift treatment.
Objective: To describe the data Analysis of CCEBDM program, running across 22 states, 2 Union Territories and 87 cities and present the analysis results of the past cycles.
Design and Methodology: “Certificate Course in Evidence Based Diabetes Management (CCEBDM)” was launched by Public Health Foundation of India in collaboration with Dr Mohan’s Diabetes Education Academy with educational grant support from MSD pharmaceuticals in 2010. The program has been endorsed by 17 National Experts, 222 Regional Faculty and 139 eminent Observers. This 12 months program with aim of enabling PCPs in diabetes management. An evidence based curriculum was conceived to enhance knowledge, skills and core competencies of PCPs in diabetes management. This Program has already completed its 4 cycles covering 21 states, 3 UTs and 87 cities across India and have trained 6943 Doctors till date. The eligibility criteria for enrollment in this program was, all the participants (PCPs) should be Medical graduate (MBBS) with at least 3 years of experience as primary care physician/clinical experience or Medical graduate (MBBS) with Post-graduate qualification.
Knowledge enhancement of the enrolled participants in the management of diabetes was analyzed by means of a questionnaire which has given before commencement (Baseline) and at the end (End line) of the program. That questionnaire consists of 25 MCQs which was based on the management of Diabetes. Furthermore, Knowledge improvement was also analyzed by means of pre-test (assessment before session commencement) and post-test (assessment after end of session) conducted for every session.
 Result: As of now, this program has completed 4 cycles (batches). Through 4 cycle 7688 participants were enrolled in this program and 6943(90%) participants has been trained in the program successfully. Over 34% of the participants were affiliated to public sector and 35% were post- graduates (MD/MS/DNB). Out of 640 districts in India, trained PCPs through this initiatives have covered 376 (59%) district. PCPs belong to different region of the county and have covered Tier 1(31%), Tier 2(38%) & Tier 3(31%) cities. 
Out of the total 7688 participants, 57% of the participants responded in baseline line survey and 61% in endline survey. 
An average increase in 3.59%, 3.67%, 4.27% and 5.21% of knowledge was seen through Cycle I, Cycle II, Cycle III and Cycle IV respectively of the course during the endline survey of the participants. 
Knowledge Improvement based on pre-test and post-test scores was found to be 2.1, 2.3, 2.3 and 2.5 on a scale of 10 through Cycle I, Cycle II, Cycle III and Cycle IV respectively.
Conclusion: The model positively enhanced the knowledge of PCPs in the management of Diabetes. PCPs perceived that after training they are more confident in treatment of diabetes (98%) and related complications (using 5 point Likert Scale). The model has been adopted by numerous state governments and has received recognition from International Diabetes Federation (IDF) and South Asian Federation of Endocrine Societies (SAFES).

Data analysis of evidence based diabetes management capacity building programs for primary care physicians in India