**3.1 Study setting and period**

This study was conducted at Dessie town hospitals (both government and private hospitals). Dessie town is located 400 km away from Addis Ababa, the capital city of Ethiopia. During the study period, there were four private and one governmental referral hospitals in Dessie town. Current report of Dessie zonal administrative office showed that these hospitals engaged in providing service for more than 3.5 million people. According to annual summative report of all diabetic clinics in Dessie town hospitals, an estimated number of 14,000 people living with T2DM were served. In each hospital, there was diabetic follow-up clinic for treatment and follow-up of people living with DM. The follow-up date in each hospital was from Monday to Friday. The actual data collection period was from February 15, to March. 152,020.
