Background Due to slum dwellers' deprivation, they are more likely to develop Type 2 Diabetes (T2D) and its complications. Type 2 Diabetes is a long-life disease that requires continuous health care utilization. One of the negative outcomes of slum-dwelling is health care underutilization. Therefore, this study aimed to understand barriers to health care utilization among those with T2D living in Tabriz slums, Iran, from the perspective of healthcare providers, in 2022. Methods A phenomenological approach was used in this study. Purposive sampling for conducting in-depth interviews was used to select 23 providers consisting of general practitioners, midwives, nutritionists, and public health experts. We conducted a content analysis using the 7 stages recommended by Colaizzi. We used four criteria recommended by Lincoln and Guba for ensuring the research’s trustworthiness. Results Three main themes and 8 categories were developed. Three main themes are 1) health care provision system barriers, including four categories: lack of motivation, non-availability of facilities and doctors, poor relationship between patients and providers, and disruption in the process 2) coverage problems, including two categories: insurance inefficiency, and limited access, and 3) contextual barriers, including two categories: environmental problems, and socioeconomic barriers. Conclusions Recommendations are presented in three levels to improve implementation. The health care system needs to modify the payment methods, Patients-providers relationship improvement, and increase the number of providers. Insurance organizations should consider sufficient coverage of costs for slum-dwellers with T2D and expand the benefits package for them. Government should consider infrastructure upgrading in slums to eliminate barriers related to slum-dwelling. Overall, health care utilization promotion needs intersection cooperation.

Background and Aims The prevalence of type 2 diabetes (T2D) is on the rise worldwide, especially in developing countries. There is a significant difference between the slum‐dwellers and other urban dwellers in terms of T2D incidence rate and access to healthcare services. This review aimed to identify barriers and facilitators to T2D management among slum‐dwellers. Methods A systematic review was conducted to identify barriers and facilitators to T2D management from January 1, 2002 to May 30, 2022. We searched MEDLINE via PubMed, Scopus, Web of Sciences, and Google Scholar. The inclusion criteria were: qualitative or mixed‐methods research, published in English, focused on slum‐dwellers and T2D or its complications, and assessed barriers and facilitators to T2D management among slum‐dwellers. Quality appraisal was conducted using the QATSDD critical appraisal tool. A thematic approach was used for data analysis and synthesis. Results A total of 17 articles were included in this review. Three analytical themes were identified: (1) Individual factors consisting of four themes: lifestyle behaviors, informational, psychological, and financial factors; (2) Health system factors consisting of three themes: patient education processes, financial protection, and service delivery; and (3) Contextual factors consisting of three themes: family support, social support, and environmental factors. Conclusion Our review disclosed that the individual, health system, and context influence T2D management among slum‐dwellers. Policymakers can use the findings of this review to reduce barriers and augment facilitators to improve healthcare utilization and self‐care management among patients with T2D in slums.

Background and Aims Slums are known as growing underprivileged areas. One of the health adverse effects of slum‐dwelling is health care underutilization. Management of type 2 diabetes mellitus (T2DM) requires an appropriate utilization. This study aimed to investigate the extent of health care utilization among slum‐dwellers with T2DM in Tabriz, Iran, in 2022. Methods We conducted a cross‐sectional study on 400 patients with T2DM living in slum areas of Tabriz, Iran. Sampling was conducted using a systematic random sampling method. A researcher‐made questionnaire was used for data collection. To develop the questionnaire, we used Iran's Package of Essential Noncommunicable (IraPEN) diseases, in which potential needs and essential health care for patients with diabetes and the appropriate time intervals for use are specified. Data were analyzed using SPSS version 22. Results Although 49.8% of patients needed outpatient services, only 38.3% were referred to health centers and utilized health services. The results of the binary logistic regression model showed that women (OR = 1.871, CI 1.170–2.993), those with higher income levels (OR = 1.984, CI 1.105–3.562), and those with diabetes complications (Adjusted OR = 1.7, CI 0.2–0.603) were almost 1.8 times more likely to utilize outpatient services. Additionally, those with diabetes complications (OR = 1.93, CI 0.189–2.031) and those taking oral medication (OR = 3.131, CI 1.825–5.369) were respectively 1.9 and 3.1 times more likely to utilize inpatient care services. Conclusions Our study showed that, although slum‐dwellers with type 2 diabetes needed outpatient services, a small percentage were referred to health centers and utilized health services. Multispectral cooperation is necessary for improving the status quo. There is a need to take appropriate interventions to strengthen health care utilization among residents with T2DM living in slum sites. Also, insurance organizations should cover more health expenditures and provide a more comprehensive benefits package for these patients.

Background As one of the disadvantaged groups, slum-dwellers face health disparities. These disparities can also be attributed to inequalities in health care utilization. Therefore, this study aimed to investigate health care utilization among patients with type 2 diabetes living in Tabriz's slums in 2022. Methods A cross-sectional study was conducted. Our study included participants who were over 18 years old, did not suffer from physical and psychological disabilities and had lived in slums for at least 5 years. 13155 patients with type 2 diabetes live in slums in Tabriz, according to the official statistics of the Vice Chancellor for Health at Tabriz University of Medical Sciences. Thus, we selected 400 patients using stratified systematic random sampling. A questionnaire was used to collect data, and SPSS version 22 was used to analyze the results. Results Of the 400 patients, 215 were female (53.8%), 323 were illiterate or could read and write (58%) and 303 had low income (75.2%). Only 15% had supplementary health insurance, while 82.3% had basic coverage. Although 49.8% of patients felt they needed outpatient services, only 38.3% were able to receive them. A blood sugar test is the most frequently received service (50%), while psychological counseling is the least frequently received consultation (3.30%). Outpatient services were used more frequently by patients with higher socioeconomic status and those with diabetes complications (P 0.05). The utilization of inpatient services was higher among older and less educated people (P 0.05). Conclusion Among slum-dwellers with type 2 diabetes, health care utilization is low. The government and health system should focus on providing adequate education about diabetes and its importance, empowering slum-dwellers to improve self-care and disease management, expanding public insurance coverage, and sufficient coverage of costs by insurance organizations.