الفهرس 
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Abstract
Appropriate treatment of common diseases and injuries is one of the :atia! elements of PHC aiming at prevention of death and disability so that people have the possibility of healthy life. The PHC management of a :e 11 should not be interpreted as merely a classical curative care leading to cription of drugs; it should mean total and comprehensive management ’abetes is a growing health problem worldwide in both developed and eloping countries and diabetes in adults is now recognized as a particular reat to public health of the third world communities, particularly those ’Ig in rapidly developing cOlU1tries and to the disadvantaged minorities in ,austriaIized nations. Primary Health Care is of first importance to diabetics and the health care ffue diabetics forms an excellent example of a disease where PHC must lY a key role. WHO had recommended that treatment and management of I,M, must be included in the fTamework of planning for the delivery of PHC all countries. PHC is of great importance to diabetic patients and their ~lies, since most care is obtained at this level. Basic care, screening for mpIications and patient education can be provided by a variety of health Jrkers . ~neaim of the present study was to: I.Assess the quality of the PHC activities provided for detection, :anagement and follow up of diabetic patients attending some rural PHC and ban health facilities in Alexandria. -Recommend minimrnn requirements and standards for quality assurance of ’etic management through PHC . Apply the recommended measures in one of the study units and its f , itrtJuation . To conduct the present study tile following techniques were used: I.A check list was designed according to WHO guidelines to assess the 1V~labiIity of resources for diabetic patients. t}A clinical sheet was designed to screen for the presence of D.M. risk lictors and to assess the number of missed suspicious cases by the PHC ~sicians . Persons having more than one risk factors were subjected to IIOdom capillary blood glucose measurement. Hn observation sheet for the physician’s performance while dealing with ’~abetic patients was designed by the researcher according to guidelines ’obtained from modern textbooks and WHO guidelines. ~A subsample of diabetic patients were subjected to FBG measurement to ~ess the level ofD.M. control by the health facility physicians. }Two interview questionnaire were designed to measure the knowledge, 8Ititude and practices concerning D.M. for the physicians and the paramedical ~An interview questionnaire for the diabetic patients was designed to f !JDe3Sure tlleir knowledge, attitude and practice as regards D.M. and to assess fueir satisfaction with the services provided. :7.The recommended measures by the researcher were applied in one of the ~!ludy facilities included: training course for the physicians, designing and ropplying of diabetic files, provision of some equipment, laboratory facilities and medications. v~uation of the effectiveness of the intervention program was done 3 Iths later by assessing the availability of equipment and supplies, sing the KAP of the physicians ( post-test) , reviewing patients files, and checking the level of D.M. control. ”!Dta were subjected to statistical analysis and interpretation. e results obtained in this study could be summarized as follows: .The catchment areas were not identified in all the study facilities and the /ices provided for diabetes control were provided through a specific clinic ~days I week in EI-Mandara H.C. only and through the general outpatient fdinics in tile remaining 3 study facilities. ~TIlere were deficiencies in the percentage of physicians trained on D.M. or ’. who had postgraduate studies in branches related to D. M. . ’-Blood glucose measurement, senun creatinine and serwn cholesterol were done only in Borg El-Arab H.C. and Abis 2 H.C. , while glycosylated Baemoglobin was not done in all the study facilities. ~Intennediate acting Sulphonylureas were available in all the study facilities except Abis 8 H. C. , while Metfonnins were available in all the study facilities. The various fonns of insulins were available in EI-Mandara H. C. only. 5-Family files were not available in all the study facilities, while daily registration records for diabetic patients, specific record for each diabetic case, also monthly reports and follow up / appointment cards were available ill EI-Mandara H. C. only. ... .ReferraI sheets were only available at EI-Mandara H.C. and Abis 2 H.C. , ., feed back was received and none of the diabetic cases in all the study ki1ities was referred during the period of the study or the intervention p-ogram . Health education were not perfonned during the period of the iUay or tlle intervention prognun . . f.D.M. is likely to occur in about 23 of the studied suspicious cases above .