Current practices and future preferences of type 2 diabetes care in Ethiopia: A qualitative study on the perspectives of patients, health professionals, and policymakers

Tigestu Alemu Desse; Kevin Mc Namara; Helen Yifter; Elizabeth Manias

doi:10.1016/j.dsx.2022.102585

Current practices and future preferences of type 2 diabetes care in Ethiopia: A qualitative study on the perspectives of patients, health professionals, and policymakers

Diabetes Metab Syndr. 2022 Aug;16(8):102585. doi: 10.1016/j.dsx.2022.102585. Epub 2022 Jul 31.

Authors

Tigestu Alemu Desse¹, Kevin Mc Namara², Helen Yifter³, Elizabeth Manias⁴

Affiliations

¹ School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia; College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. Electronic address: talemu@deakin.edu.au.
² Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Geelong, Australia; Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia.
³ College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
⁴ School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia.

PMID: 35939942
DOI: 10.1016/j.dsx.2022.102585

Abstract

Background and aims: This study aimed to examine perspectives of patients, health professionals, and policymakers on current practices and their future preferences for type 2 diabetes care in a tertiary hospital in Ethiopia.

Methods: An exploratory qualitative study was undertaken through interviews and focus groups with patients, health professionals, and policymakers. The participants were purposively sampled. Thematic analysis was undertaken.

Results: Fifty-nine participants were involved in the study. Participants' perspectives on current practices and future preferences comprised three themes: organisation of type 2 diabetes care delivery and infrastructure; continuity of care; and structured diabetes education. The current organisation comprised physicians, such as endocrinologists and endocrinology fellows, and nurses. Some nurses received training on diabetes foot and diabetic eye, which enabled patients to receive diabetes foot and diabetic eye care, respectively. The hospital lacked essential resources, such as medications, laboratory and diagnostic services, and diabetes educators, which hindered patient-centred care. Patients complained that the physical set-up at the hospital was not conducive to their privacy during consultations. Participants reported infrequent patient follow-up and monitoring, which contributed to uncontrolled diabetes. Future preferences involved access to essential resources and comprehensive diabetes care, such as structured diabetes education for improved patient outcomes. Participants sought out the development of tailored and context-specific diabetes management approaches that could meet specific patient needs and preferences.

Conclusions: The findings have implications for designing patient-centred diabetes care tailored to the hospital's context and key stakeholders' preferences. This tailoring requires strong leadership to ensure availability of essential resources.

Keywords: Diabetes; Diabetes care; Diabetes education; Ethiopia; Medication therapy management; Patient; Sub-Saharan Africa.

MeSH terms

Diabetes Mellitus, Type 2*
Diabetic Foot*
Ethiopia
Health Personnel
Humans
Qualitative Research