Evaluation of a diabetes decentralization program in rural Madagascar using the RE-AIM framework.

ABSTRACT: Diabetes is a significant cause of disabilities and deaths in Africa. In Madagascar, diabetes causes an estimated 5,000 deaths yearly. There are many barriers to diabetes care in Madagascar, and a key barrier is health systems readiness to provide care, especially in rural areas. To mitigate this, the non-governmental organization (NGO) Pivot and the Ministry of Public Health (MoPH) jointly implemented a diabetes decentralization program in Ifanadiana, a rural district of Madagascar. This program included advocacy; mass screening; training of healthcare workers (HCWs); procurement of equipment, medications and consumables; establishment of a dedicated diabetes care day at primary health centers (PHCs); and support groups for patients. This study evaluated the implementation of this multifa

SUBMITTER: Mugisha N 

PROVIDER: S-EPMC12935218 | biostudies-literature | 2026

REPOSITORIES: biostudies-literature