Strength and limitations
DIABETIC RETINOPATHY
The strength of our study is that it is one of the first studies in Nepal that includes health care professionals involved in DM management and strengthens the referral for the screening of diabetic retinopathy. The pilot gave us information on re-comprehension of the content of the materials to be used for the main study.Due to COVID-19, the number of selected health personnel participating in health education was less than expected. We did not have a control hospital to compare our intervention and the effect of the referral pathway in 2 hospitals, which could limit our study’s generalizability. Due to COVID-19 the number of patients attending Scheer and REMEH might have been affected. It will be useful to have further studies with a qualitative component to understand the barriers faced by health personnel on the referral process and reasons for delays, if any.