Data analysis
The baseline and post intervention patient referral data was compared and the proportional increase due to intervention was calculated. The change in knowledge of health personnel was assessed by pre and post assessment questionnaire. In patients’ data, Information on DR and duration of DM was collected, visual acuity and stage of DR was noted. Descriptive analysis for the same was done. Information on the referred data was collected from the intervention hospital. Mean median and Standard deviation were calculated for the demographic variables. Z test was applied to determine the number of referrals to justify the research hypothesis that the proportion of referral cases after the intervention is improved. The change in mean knowledge after the intervention, i.e. the mean knowledge score pre and post-intervention are tested using the paired t-test.Data was analyzed using excel and Epi info 7. The ethical approval for this study was obtained from the Ethical Review Board of Nepal Health Research Council on 22/12/2020(ERB Protocol Registration Number#582/2020P).Protocol of the study was published on August 21, 2021, in JMIR Publications. Clinical trials registration: NCT04829084 [