Evaluating diabetes and diabetic retinopathy healthcare services in Jakarta, Indonesia: current challenges and opportunities for improvement

The rising prevalence of DM has become a serious global health challenge, including in Indonesia. Uncontrolled long-standing DM can cause many complications, such as DR, which may lead to blindness. Globally, one in three DM patients experience DR, whereas, in Jakarta, 18% of people have DR and 19% of those have VTDR. Early detection and prompt treatment are known to lower the rate of blindness caused by DM successfully, therefore developing effective screening programs is mandatory. To evaluate the current healthcare services for Diabetes Mellitus (DM) and Diabetic Retinopathy (DR) in Jakarta, identifying gaps and opportunities for improvement and prevention program planning. A cross-sectional survey approach was used to analyze DM and DR management in Jakarta, conducted in March-May 2024. Respondents were selected based on WHO-TADDS recommendations with adjustments. A total of 33 respondents were chosen to complete an online questionnaire using WHO TADDS protocol, which contained scores to each item concerned. The final score was determined based on the most frequently chosen responses and was analysed quantitatively. Each of the participants will then be invited again to elaborate the chosen score, and when in disparity, consensus was achieved through discussion. Of 33 contacted respondents, 31 (93.9%) completed the survey. While 80.6% agreed that diabetes is a priority in Jakarta, only 41.9% recognized DR as a priority, with 16.1% aware of the national guideline for DR management. This highlights the gap between DM and its complication screening and lack of awareness of DR management guidelines. DM services are available at various levels, but they are limited by lack of awareness, financial constraints, and preference for alternative treatments. Up to this day, only 22.6% reported incidental screening, supporting the low screening rates of DR in Jakarta. This condition is also aggravated by inequality of DM and DR training and essential DR diagnostic tools in primary care. The study identifies the need for systematic DR screening programs, by raising awareness and implementation of clinical guidelines, and also enhancing access to diagnostic tools to provide comprehensive and accessible DM and DR healthcare services.