Diabetes is a major cause of morbidity and mortality worldwide yet preventable. Complications of undetected and untreated diabetes result in serious human suffering and disability.rnIt negatively impacts on individuals social economic status threatening economic prosperity. There is a scarcity of data on health system diabetes service readiness and availability inrnKenya which necessitated an investigation into the specific availability and readiness of diabetes services
to assess the service readiness and availability of healthcare facilities in terms of diabetes management capacity
A cross sectional descriptive study was carried out using the Kenya service availability and readiness mapping tool in 598 randomly selected public health facilities in 12 purposively selected counties. Ethical standards outlined in the 1964 Declaration of Helsinki and its later amendments were upheld throughout the study. Health facilities were classifiedrninto primary and secondary level facilities prior to statistical analysis using IBM SPSS version 25. Exploratory data analysis techniques were employed to uncover the distribution structure of continuous study variables. For categorical variables descriptive statistics in terms of proportions frequency distributions and percentages were used
Of the 598 facilities visited 83.3 were classified as primary while 16.6 as secondary. A variation in specific diabetes service availability and readiness was depicted in the 12 counties and between primary and secondary level facilities. Human resource for health reported a low mean availability 46 95 CI 44-48 with any NCDs specialist and nutritionist the least carder available. Basic equipment and diagnostic capacity reported a fairly high meanrnreadiness 73 95 CI 71-75 and 64 95CI 60-68 respectively. Generally primary health facilities had low diabetic specific service availability and readiness compared to secondary facilities: capacity to cope with diabetes increased as the level of care ascended to higher levels
Although the country has made significant progress in improving diabetes healthcare services readiness and availability there are still gaps that need to be addressed to improve service delivery. A variation in specific service availability and readiness was depicted in the 12 counties and between primary and secondary-level facilities. Majority of the primary level facilities were not ready to offer diabetes screening and management. They had suboptimal readiness scores and limited availability of services to manage diabetes based on the specific service domain assessed. Although services are fairly availability at secondary level there were critical gaps that need to be filled so to enhance diabetes readiness. Health care facilities ideally should have the capacity to provide the services recommended at different tiers that is service readiness and service availability. This would translate to early detection and initiation of treatment which is a critical step in averting or delaying the onset of diabetes and related complications.