Task-sharing interventions for improving control of diabetes in low-income and middle-income countries: a systematic review and meta-analysis

BACKGROUND: Task-sharing interventions using non-physician health-care workers might be a potential diabetes management strategy in health systems that are constrained by physician shortages, such as those in low-income and middle-income countries (LMICs). METHODS: and FBS with 95% CIs. Our study protocol was registered in the PROSPERO database (CRD42018081015). FINDINGS: =71%). Only one study reported on FBS when tasks were delivered by dietitians, with a mean difference of -35·00 mg/dL (-65·96 to -4·04). INTERPRETATION: Task sharing interventions with non-physician healthcare workers show moderate effectiveness in diabetes management in LMIC settings. Although relatively high heterogeneity limits the interpretation of the overall findings, interventions led by pharmacists and nurses in LMICs with relatively high physician density are effective strategies in the management of diabetes. FUNDING: Wellcome Trust-Department of Biotechnology India Alliance.