Training of Community Health Workers in Diabetes Lead to Improved Outcomes for Diabetes Screening and Management in Low- and Middle-Income Countries: Protocol for a Systematic Review

Background: Diabetes is a growing concern worldwide, particularly in low- and middle-income countries (LMICs). Type 2diabetes mellitus constitutes a significant proportion of cases and is associated with debilitating microvascular complications.Type 2 diabetes mellitus is steadily increasing among the LMICs where many barriers to health care exist. Thus, task shifting tocommunity health workers (CHWs) has been proposed as a solution to improve diabetes management in these settings. However,CHWs often lack the necessary training to manage diabetes effectively. Thus, a systematic review is required to present evidenceof the highest degree for this intervention. Objective: This study aims to establish the protocols for a systemic review. Methods: Using the Participants Intervention Comparator Outcome Time Study Design (PICOTS) framework, this study outlinesa systematic review aiming to evaluate the impact of training programs for CHWs in diabetes management in LMICs. Quantitativestudies focusing on CHWs, diabetes training, focusing on diabetes management outcomes like hemoglobin A1clevels and fastingblood glucose levels, between January 2000 and December 2023 and found on databases such as PubMed, Ovid MEDLINE,Evidence Based Medicine Reviews, BASE, Google Scholar, and Web of Science will be included. We will include randomizedcontrolled trials but will also include observational studies if we find less than 5 randomized controlled trials. An author committeeconsisting of 3 reviewers will be formed, where 2 reviewers will conduct the review independently while the third will resolveall disputes. The Cochrane Methods Risk of Bias Tool 2 will be used for assessing the risk of bias and the Grading ofRecommendations, Assessment, Development and Evaluation approach for the meta-analysis and narrative synthesis analysiswill be used. The results will be presented in a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)diagram. Results: The review will begin in May 2024 and conclude in 3 months. Conclusions: The review will synthesize existing evidence and provide insights into the effectiveness of such programs,informing future research and practice in diabetes care in LMICs.