Diabetes care in urban India: Perceptions from primary healthcare providers

Non-communicable diseases (NCDs), including diabetes, are rising rapidly in India, accounting for 61 % of all deaths. Despite national programs for NCDs, effective diabetes management is hindered due to several factors. However, in India, NCD care has been integrated with primary healthcare. This study aims to explore and understand the experiences of healthcare providers involved in diabetes care delivery at urban PHCs in Jodhpur, Rajasthan. A descriptive phenomenological qualitative design was employed. In-depth interviews (IDIs) with Medical Officers and ANMs, and focus group discussions (FGDs) with ASHAs were conducted across four UPHCs. Data were transcribed, coded using NVivo 14+, and thematically analysed using inductive and deductive approaches. Key themes emerged: (i) role of health workers in diabetes care, (ii) IT-based digital tools used for diabetes care, (iii) challenges healthcare workers face in diabetes care, and (iv) solutions for improving diabetes management. It highlights the strengths and challenges in service delivery, particularly using digital tools like the NP-NCD portal and the NCD-related app. This study offers a comprehensive analysis of urban-based healthcare providers' perceptions of diabetes care. The study warrants addressing the challenges identified through better training, improved infrastructure, and resource allocation. It contributes to theory by extending the phenomenological understanding of healthcare service delivery into the context of digital health integration for chronic disease management in resource-constrained urban primary care settings. Further, the study provides recommendations for policymakers to improve diabetes care services, benefiting urban areas of India.