Facilitators and barriers for early detection and management of type II diabetes and hypertension, Sidama Regional State, Ethiopia
a qualitative study
DOI:
https://doi.org/10.20372/ejphn.v6i1.359Keywords:
Type-II DM, hypertension, facilitators, barriers, adults, early diagnosisAbstract
Background: The burden of Non-communicable diseases (NCD) is rapidly increasing in Ethiopia and remains public health problem. The diseases have led to a double burden of diseases in the country.
Method: it was a qualitative study designed to explore facilitators and barriers for early detection and management of type II diabetes and hypertension, Sidama Regional State, Ethiopia. A total of four focused group discussions, twelve key informant interviews and twelve in-depth interviews were conducted; the data was collected using a semi-structured interview guide. The interviews were transcribed, coded, and analysed using a content analysis approach. The study was conducted in the selected governmental primary health care units (health centres and primary hospitals) from February to June 2021.
Results: The primary identified demand-side facilitators were; fear of early death, family history, exposure to mass media, knowledge of NCDs, and illness of unknown origin. As the same time the identified supply-side facilitators were. Concern of the federal government, the availability of the right policy, and the willingness of some health care providers. Also, financial problems, the unwelcoming approach of the health care providers, knowledge deficit, and lack of trust in public health facilities are recognized as demand-side barriers. In addition, lack of trained medical personnel, unavailability of screening and diagnostic materials, and dissatisfaction of the primary health care unit workers were identified as supply-side barriers to early detection and management of diabetes and hypertension.
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Al Shafaee MA, Al-Shukaili S, Rizvi SGA, Al Farsi Y, Khan MA, Ganguly SS, et al. (2008). Knowledge and perceptions of diabetes in a semi-urban Omani population. BMC Public Health, 8: 1–8. https://doi.org/10.1186/1471-
-8-249. https://doi.org/10.1186/1471-2458-
-249
Albagawi BS & Jones LK (2016). Quantitative exploration of the barriers and facilitators to nurse-patient communication in Saudia Arabia. Journal of Hospital Administration, 6(1): 16. https://doi.org/10.5430/jha.v6n1p16
American Diabetes Association (2018). Standards of Medical Care in Diabetes—2018 Abridged for Primary Care Providers. Clinical Diabetes, 36(1): 14-37. https://doi.org/10.2337/cd17-0119 Banatvala N & Small R (2020). Responding to non- communicable diseases during and beyond the COVID-19 pandemic. British Medical Journal
Blogs, 5: 19.
Bigna JJ & Noubiap JJ (2019). The rising burden of non-communicable diseases in Sub-Saharan Africa. The Lancet Global Health, 7(10): e1295– e1296. https://doi.org/10.1016/S2214-109X(19) 30370-5
Bhojani U, Mishra A, Amruthavalli S, Devadasan N, Kolsteren P, De Henauw, et al. (2013). Constraints faced by urban poor in managing diabetes care: patients’ perspectives from South India. Global Health Action, 6(1): 2258.
Blasco-Blasco M, Puig-García M, Piay N, Lumbreras B, Hernández-Aguado I & Anne Parker L (2020). Barriers and facilitators to successful management of type 2 diabetes mellitus in Latin America and the Caribbean: A systematic review. Plos One, 15(9):e0237542
Bollyky TJ, Templin T, Cohen M & Dieleman JL (2017). Lower-income countries that face the most rapid shift in noncommunicable disease burden are also the least prepared. Health Affairs, 36(11): 1866–1875. https://doi.org/10.1377/ hlthaff.2017.0708
Castro B, Ing L, Park Y, Abrams J & Ryan M (2018). Addressing noncommunicable disease in Dominican Republic: Barriers to hypertension and diabetes care. Annals of Global Health, 84(4): 625–629. https://doi.org/10.29024/ aogh.
Chang H, Hawley NL, Kalyesubula R, Siddharthan T, Checkley W, Knauf F, et al. (2019). Challenges to hypertension and diabetes management in rural Uganda: A qualitative study with patients, village health team members, and health care professionals. International Journal for Equity in Health, 18(1): 1–14. https://doi.org/10.1186/s12939-019-0934-1
Choi J, Choi JY, Lee SA, Lee KM, Shin A, Oh J, et al. (2019). Association between family history of diabetes and clusters of adherence to healthy behaviors: Cross-sectional results from the health examinees-gem (hexa-g) study. BMJ Open, 9(6): 20.
Damasceno, A. (2016). Noncommunicable Disease. In Heart of Africa: Clinical profile on evolving burden of heart disease in Africa. 1–13. https://doi.org/10.1136/ bmjopen-2018-025477
Endriyas M, Mekonnen E, Dana T, Daka K, Misganaw T, Ayele S, et al. (2018). Burden of NCDs in SNNP region, Ethiopia: A retrospective study. BMC Health Services Research, 18(1): 1– 7. https://doi.org/10.1186/s12913-018-3298-0
Ethiopian Federal Ministry of Health (2015). Health Sector Transformation Plan (2015/16-2019/20). Pp 1-118.
Ethiopian Federal Ministry of Health (2016). Ethiopia_National Strategic Action Plan (NSAP) for Prevention and Control of Non- Communicable Diseases. Pp. 1–265.
Einarson TR, Acs A, Ludwig C, Panton UH (2018). Prevalence of cardiovascular disease in type II diabetes: a systematic literature review of scientific evidence from across the world in 2007-2017.S, Marczak L, et al. (2017). Global burden of hypertension and systolic blood pressure of at least 110 to 115mmHg, 1990-2015. JAMA - Journal of the American Medical Association, 317(2):8
Gebreyes YF, Goshu DY, Geletew TK, Argefa TG, Zemedu TG, Lemu KA, et al. (2018). Prevalence of high blood pressure, hyperglycemia, dyslipidemia, metabolic syndrome and their determinants in Ethiopia: Evidences from the National NCDs STEPS Survey, 2015. PLoS ONE, 13(5): 1–18. https://doi.org/10.1371/ journal.pone.0194819
Getachew S, Te10sfaw A, Kaba M, Wienke A, Taylor L, Kantelhardt EJ, et al. (2020). Perceived barriers to early diagnosis of breast Cancer in south and southwestern Ethiopia: a qualitative study. BMC Women’s Health, 20(1): 38. https://doi.org/10.1186/s12905-020-00909-7.
Gowani A, Ahmed HI, Khalid W, Muqeet A,
Abdullah S, Khoja S, et al. (2016). Facilitators and barriers to NCD prevention in Pakistanis- invincibility or inevitability: A qualitative research study. BMC Research Notes, 9(1): 1–9. https://doi.org/10.1186/s13104-016-2087-2
Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U & Shaw JE (2014). Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Research and Clinical Practice, 103(2): 137–149. https://doi.org/10.1016/j.diabres.2013.11.002
Heller DJ, Kumar A, Kishore SP, Horowitz CR, Joshi R & Vedanthan R (2019). Assessment of Barriers and Facilitators to the Delivery of Care for Noncommunicable Diseases by Nonphysician Health Workers in Low- and Middle-Income Countries: A Systematic Review and Qualitative Analysis. JAMA Network Open, 2(12): 18.
Jimenez Carrillo M, León Garciá M, Vidal N, Bermúdez K & De Vos P (2020). Comprehensive primary health care and non-communicable diseases management: A case study of El Salvador. International Journal for Equity in Health, 19(1): 13.
Kankeu HT, Saksena P, Xu K & Evans DB (2013). The financial burden from non-communicable diseases in low- and middle-income countries: A literature review. Health Research Policy and Systems, 11(1): 9.
Kok MC, Kane SS, Tulloch O, Ormel H, Theobald S, Dieleman M, et al. (2015). How does context influence performance of community health workers in low- and middle-income countries? Evidence from the literature. Health Research Policy and Systems, 13(1): 27.
Kumah E, Otchere G, Ankomah SE, Fusheini A, Kokuro C, Aduo-Adjei K, et al. (2021). Diabetes self-management education interventions in the WHO African Region: A scoping review. Plos One, 16(8): 1–20.
Martinez R, Lloyd-Sherlock P, Soliz P, Ebrahim S, Vega E, Ordunez P, et al. (2020). Trends in premature avertable mortality from non- communicable diseases for 195 countries and territories, 1990–2017: a population-based study. The Lancet Global Health, 8(4): e511–e523. https://doi.org/10.1016/S2214-109X(20)30035-8 Maurel F, Lepelletier T, Moreau J, Noeuveglise C, & Lancelot B (2008). Bilan prospectif besoins- ressources in Seine-Normandie (partie hydrologique). Houille Blanche, 5: 45–52.
https://doi.org/10.1051/lhb:2008053
Mbuya FE, Fredrick F & Kundi B (2014). Knowledge of diabetes and hypertension among members of teaching staff of higher learning institutions in dar es salaam, Tanzania. Tanzania Journal of Health Research, 16(2): 1–7. https://doi.org/10.4314/thrb.v16i2.5
Moges W, Solomon E & Worku A (2020). Level of
Nurses to Patients Communication and Perceived Barriers in Government Hospitals of Bahir Dar City, Ethiopia, 2020. Clinical Journal of Nursing Care and Practice, 4(1): 012–026. https://doi.org/10.29328/journal.cjncp.1001023
National Institutes of Health (2005). Family history and high blood pressure. Natinal Heart, Lung and Blood Institude. Pp 4.
Nowell LS, Norris JM, White DE & Moules NJ (2017). Thematic Analysis: Striving to Meet the Trustworthiness Criteria. International Journal of Qualitative Methods, 16(1): 27.
Nundy S & Han E (2012). New Technology Needs for Noncommunicable Diseases in Developing Countries : a landscaping study. Results for Development Institute. Pp 1–60.
Ranasinghe P, Ishara MH, Jayasekara MDT, Jayawardena R & Katulanda P (2015). Knowledge and perceptions about diet and physical activity among Sri Lankan adults with diabetes mellitus: a qualitative study. BMC Public Health, 15: 1160.
Rasul FB, Sarker M, Yasmin F & De Allegri M (2022). Exploring health-seeking behavior for non-communicable chronic conditions in northern Bangladesh. Plos Global Public Health, 2(6): e0000497. https://doi.org/10.1371/ journal.pgph.0000497
Rawal L, Jubayer S, Choudhury SR, Islam SMS & Abdullah AS (2021). Community health workers for non-communicable diseases prevention and control in Bangladesh: a qualitative study. Global Health Research and Policy, 6(1): 1–10. https://doi.org/10.1186/s41256-020-00182-z
Russell S, Sturua L, Morgan J, Topuridze M, Blanton C, Hagan L, et al. (2019). City, University of London Institutional Repository, 25: The burden of non-communicable diseases and their related risk factors in the country of Georgia, 2015. BMC Public Health, 19(Suppl 3): 4. Shiferaw F, Letebo M, Misganaw A, Feleke Y, Gelibo T, Getachew T, et al. (2018). Non- communicable Diseases in Ethiopia: Disease burden, gaps in health care delivery and strategic directions. Ethiopian Journal of Health
Development, 32(3): 12.
Shiferaw WS, Gatew A, Afessa G, Asebu T, Petrucka PM & Aynalem YA (2020). Assessment of knowledge and perceptions towards diabetes mellitus and its associated factors among people in Debre Berhan town, northeast Ethiopia. PLoS ONE, 15(10): 1–13. https://doi.org/10.1371/journal.pone.0240850
Shiroya V, Shawa N, Matanje B, Haloka J, Safary E, Nkhweliwa C, et al. (2021). Reorienting primary
health care services for non-communicable diseases: A comparative preparedness assessment of two healthcare networks in malawi and Zambia. International Journal of Environmental Research and Public Health, 18(9): 7. https://doi.org/10.3390/ijerph18095044 Shrivastava SRB, Shrivastava PS & Ramasamy J (2013). Role of self-care in management of diabetes mellitus. Journal of Diabetes and
Metabolic Disorders, 12:14
Tiruneh SA, Bukayaw YA, Yigizaw ST & Angaw DA (2020). Prevalence of hypertension and its determinants in Ethiopia: A systematic review and meta-analysis. PLoS ONE, 15(12): 12. https://doi.org/10.1371/journal.pone.0244642
UNDP (2017). Preventing and controlling non- communicable diseases. United Nations Development Programme, January, 1–16. http://www.undp.org/content/undp/en/home/libr arypage/hiv-aids/preventing-and-controlling- non-communicable-diseases0.html
Vladislav D, Workneh A, Shiferaw F, Small R & Banatvala N (2019). Prevention and control of noncommunicable diseases in Ethiopia: The case for investment, including considerations on the impact of khat. Pp 41.
Wamai RG (2009). Reviewing Ethiopia’s health system development. Japan Medical Association Journal, 52(4): 279–286.
Witter S, Zou G, Diaconu K, Senesi RGB, Idriss A, & Walley J (2020). Opportunities and challenges for delivering non-communicable disease management and services in fragile and post- conflict settings : perceptions of policy-makers and health providers in Sierra Leone. Pp 1–14.
World Health Organization (2019). World Health Statistics 2019: Monitoring Health for the SDGs, Sustainable Development Goals, Geneva. Pp 120.
World Health Organization (2020). WHO methods and data sources for global burden of disease estimates 2000-2019. November. Pp 86.
World Health Organization (2019). Use of Commmunity Health Workers to Manage and Prevent Non-communicable Diseases. In World Health Organization, 6(1). Zeru MA, Tesfa E, Mitiku AA, Seyoum A, Bokoro TA(2021). Prevalence and risk factors of type-2 diabetes mellitus in Ethiopia:
World Health Organization (2015). From MDGs to SDGs: General Introduction. WHO, 2(2): 45.
World Health Organization (2019). https://int/news- room/ fact- sheets/detail/non communicable- diseases. Pp 35.
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