The management of diabetes at primary level in South Africa: the results of a facility-based assessment

J R Soc Promot Health. 1998 Dec;118(6):338-45. doi: 10.1177/146642409811800612.


Diabetes is a widespread condition in South Africa and is often managed at primary level health facilities. This study aimed to assess the quality of diabetes management using a rapid assessment approach, focusing on three indicators as proxy measurements of quality: the regularity of blood glucose level (BGL) measurement; the percentage of patients whose BGLs were within 'acceptable' limits (under 10.0 mmol/l) on at least 75% of visits; the rate at which action was taken in response to high BGLs. Five sites were included in the study, including public and private, doctor- and nurse-based facilities. A total of 128 records were examined. Only 33% of all records were found to be well-managed according to the study criteria. None of the individual facilities were found to have more than 40% of patients achieving BGLs within the study limits. Some obstacles to good glycaemic control were costs to patients, transport problems, a lack of health education and shortcomings in clinical expertise. Policy implications and recommendations are suggested.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose / analysis
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / diagnosis*
  • Diabetes Mellitus / therapy*
  • Family Practice / standards
  • Female
  • Health Policy
  • Health Services Research
  • Humans
  • Male
  • Medical Audit
  • Primary Health Care / methods
  • Primary Health Care / standards*
  • Quality Assurance, Health Care
  • Quality of Health Care*
  • South Africa


  • Blood Glucose