Walking a tightrope: perspectives of non-degree allopathic providers (NDAPs) on providing diabetes and hypertension care in urban informal settlements of Mumbai Metropolitan Region

The document examines the role of Non-Degree Allopathic Providers (NDAPs) in managing diabetes and hypertension within urban informal settlements in the Mumbai Metropolitan Region. These practitioners, who lack formal medical qualifications, are often the first point of contact for healthcare in these communities, providing accessible and affordable care. The study identifies diverse roles NDAPs play, including offering symptomatic relief, conducting preliminary diagnostics, initiating treatment, referring patients to specialists, and following up on care.

NDAPs frequently operate as "family doctors," emphasizing community trust and cost-effectiveness. However, their involvement in managing non-communicable diseases (NCDs) like diabetes and hypertension varies based on individual capability, network connections with qualified practitioners, and the socio-economic dynamics of the area. While some NDAPs provide basic management and referrals, others focus solely on symptomatic relief due to risk aversion and limited resources.

Challenges faced by NDAPs include patient reluctance for early diagnosis and adherence to long-term treatments, compounded by the informal nature of their practice. The study suggests potential benefits of integrating NDAPs into formal health systems through training, regulatory oversight, and incentivized collaboration, which could improve NCD management while addressing gaps in healthcare access in resource-constrained settings.