Ambivalence, resource constraints, and non-compliance; the bane of healthcare providers in the screening and management of Gestational Diabetes in Northern Ghana

Abstract

Background Studies on healthcare providers’ experiences on screening and management of GDM are rare in the northern part of Ghana. Hence, this study sought to explore the experiences of healthcare providers on screening and management of GDM. Materials and methods This was a qualitative cross-sectional study among five key informants who were involved in screening and management of GDM. Both facilities and key informants were purposively sampled. An interview guide was designed to elicit information on gestational diabetes screening and management experiences. Data were analysed using thematic content analysis. Results Two themes emerged for both screening and management experiences; the screening experiences were resource-related experiences which comprised of financial constraints, lack/inadequate tools for screening and insufficient number of dedicated healthcare personnel and experiences with patient emotional feedback which were clients being worried, shocked, confused, uncertain about how they felt or unbothered based on their knowledge of GDM, being fed-up with treatment, and lack of support from family members. The themes for management were diet and exercise, and oral medications. HCPs experience issues of non-compliance which were mainly caused by poverty, they also felt that the most important resources required for the effective screening and management of GDM were the tools for screening and dedicated staff. The first line of action for GDM management was diet and exercise, oral medications was the last line of action. Conclusion This study observed that ambivalence of clients, resource constraints namely financial constraints, lack/inadequate tools for screening and inadequate number of healthcare providers were key issues in the screening and management of Gestational Diabetes; diet and exercise, and oral medications were the main approaches for the management of Gestational Diabetes. This study provides insights on healthcare providers’ experiences with screening and management of GDM which could be relevant for health advocacy and social and behavior change communication. It could also be relevant for health planning and policies as it provides insights on the resources needed to effectively screen and management GDM.