Barriers for detection and management of gestational diabetes mellitus in southern Ethiopia: A qualitative study

Woticha, Eskinder Wolka; Deressa, Wakgari; Reja, Ahmed

doi:10.1016/j.dsx.2019.04.005

Cited by 8 publications

(7 citation statements)

References 14 publications

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“…In Ethiopia, health care providers screen and initiate counseling for lifestyle modification during the early stages of the diagnosis, followed by a prescribed insulin regimen. Nevertheless, effective implementation of these strategies once again is hindered [ 42 , 43 ]. The current study found out that premature rupture of the membrane was significantly associated with perinatal asphyxia which is consistent with other findings from Pakistan [ 30 , 44 ], Ghana [ 34 ], and Tanzania [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Perinatal asphyxia and associated factors among neonates admitted to a specialized public hospital in South Central Ethiopia: A retrospective cross-sectional study

Mamo¹,

Teshome

Tesfaye

et al. 2022

PLoS ONE

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Introduction Perinatal asphyxia continues to be a significant clinical concern around the world as the consequences can be devastating. World Health Organization data indicates perinatal asphyxia is encountered amongst 6–10 newborns per 1000 live full-term birth, and the figures are higher for low and middle-income countries. Nevertheless, studies on the prevalence of asphyxia and the extent of the problem in poorly resourced southern Ethiopian regions are limited. This study aimed to determine the magnitude of perinatal asphyxia and its associated factors. Methods A retrospective cross-sectional study design was used from March to April 2020. Data was collected from charts of neonates who were admitted to NICU from January 2016 to December 31, 2019. Result The review of 311 neonates’ medical records revealed that 41.2% of the neonates experienced perinatal asphyxia. Preeclampsia during pregnancy (AOR = 6.2, 95%CI:3.1–12.3), antepartum hemorrhage (AOR = 4.5, 95%CI:2.3–8.6), gestational diabetes mellitus (AOR = 4.2, 95%CI:1.9–9.2), premature rupture of membrane (AOR = 2.5, 95%CI:1.33–4.7) fetal distress (AOR = 3,95%CI:1.3–7.0) and meconium-stained amniotic fluid (AOR = 7.7, 95%CI: 3.1–19.3) were the associated factors. Conclusion Substantial percentages of neonates encounter perinatal asphyxia, causing significant morbidity and mortality. Focus on early identification and timely treatment of perinatal asphyxia in hospitals should, therefore, be given priority.

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Section: Discussionmentioning

confidence: 99%

Perinatal asphyxia and associated factors among neonates admitted to a specialized public hospital in South Central Ethiopia: A retrospective cross-sectional study

Mamo¹,

Teshome

Tesfaye

et al. 2022

PLoS ONE

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“…This finding complements another research report on gestational diabetes management in Ethiopia. 54 This problem can be solved by availing the materials at the lower levels, and engaging stakeholders to fill the gaps. 55 , 56 Additionally, our in-depth interview results showed that poor knowledge and lack of skills among the health workers, frequent stock-outs of supplies, unaffordability of some important services, and organizational neglect of diabetes-related activities were among the hindering factors to curve the rising diabetes burden.…”

Section: Discussionmentioning

confidence: 99%

“…53 Based on our study findings lack of trained health workers and low patient awareness levels were among the barriers to delivering quality diabetes screening and management in SNNPRS, and this finding substantiates a study result from Ethiopia where training shortages for health workers and low awareness levels of patients were among the barriers to diabetes management. 54 The possible justification for this gap is that Ethiopia's healthcare system is yet struggling with poor staffing, skilled health workforce shortage, and incompetency, specifically the lower and midlevel health workers, low health literacy level of people, and lack of quality training and education system.…”

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confidence: 99%

A Mixed Methods Multicenter Study on the Capabilities, Barriers, and Opportunities for Diabetes Screening and Management in the Public Health System of Southern Ethiopia

Habebo¹,

Jaafaripooyan²,

Mosadeghrad³

et al. 2022

DMSO

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Background More than half of diabetics’ in Ethiopia live undiagnosed, and the majority of those who already knew their status also struggle to manage their diseases. However, the underlying challenges are less understood in the study area. Therefore, this study aimed to assess diabetes screening and management capabilities, barriers, and opportunities in southern Ethiopia. Methods We applied a mixed methods study. To assess the healthcare systems’ capabilities, we collected quantitative data from randomly selected ten hierarchically organized healthcare facilities, and purposive maximum variation sampling was applied to recruit twenty-nine individuals for face-to-face in-depth interviewing. The interviews were audio recorded, transcribed verbatim, thematically analyzed, and presented accordingly. Results Our study findings indicated that there were good opportunities and encouraging capabilities like government commitment and expansion of services to improve diabetes screening and management in southern Ethiopia. Nevertheless, poor governance, the system’s structural problems, skilled professionals’ inaccessibility and lack of teamwork, poor service integration, poor planning, and lack of monitoring and evaluation mechanisms have been hampering the service delivery at the system level. While service unaffordability, low awareness level, and lifestyle modification problems were the main challenges at the patient level. Furthermore, outdated paper-based medical record documentation, frequent essential drug stock-outing, essential laboratory service interruptions, and none-use of some available services like HbA1c have been contributing to the barriers. Conclusion Despite favorable capabilities available, diabetes management in southern Ethiopia has been struggling with solvable structural defects, poor service delivery and inaccessibility, and patients’ poor lifestyle modification. Therefore, public health system restructuring, optimum financing, computerization of medical records documentation, and health system and patient capacity building are strongly recommended interventions to tackle the problem at the grass-root level.

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“…Inadequate health care provider knowledge on GDM, late ANC attendance as well as lack of standard guidelines, supplies and equipment for screening and management of GDM are also major barriers to early detection and management of GDM in LMICs [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Level of and factors associated with awareness of gestational diabetes mellitus among pregnant women attending antenatal care at Kawempe National Referral Hospital: a cross sectional study

Byakwaga

Sekikubo

Nakimuli

2021

BMC Pregnancy Childbirth

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Background The burden of Gestational diabetes mellitus (GDM) is significantly increasing worldwide and the disorder causes substantial short term and long-term adverse effects both to the mother and the unborn baby. Public health measures to increase awareness of GDM among pregnant women may aid in prevention of the disease through life style modification, screening, early diagnosis and management but very few studies have assessed awareness of GDM among pregnant women in sub Saharan Africa and none of these are from Uganda. This study therefore sought to evaluate the level of and factors associated with awareness of GDM among pregnant women attending antenatal care at Kawempe National Referral Hospital (KNRH), the busiest obstetric unit in Uganda, so as to assess their health sensitization needs. Methods This was a cross-sectional study. We recruited 403 participants at 30 weeks of gestation and above after giving written informed consent. Systematic sampling was used to select participants and data was collected using pretested interviewer-administered questionnaires. The collected data was entered in Epidata version 4.2 and exported to Stata for analysis. Continuous variables were summarized using mean and standard deviation. Categorical variables were summarized using frequencies and proportions. Factors associated with awareness were assessed at both bivariate and multivariate levels. Results Four hundred three pregnant women were recruited, majority (35.5 %) were between 20 and 24 years and their mean age was 26.6 years. Only 125 (31 %) participants were aware of GDM. Age and educational level were significantly associated with awareness of GDM. Women aged 35 years and above were more likely to be aware of GDM (OR = 2.34 (95 % CI = 1.14–4.81) p = 0.021. Women with primary education or no education were less likely to be aware (OR = 0.48 (CI 0.24–0.96) p = 0.038. Conclusions Awareness of GDM was poor among study participants. There is need to improve the health education programs in order to increase awareness of GDM among women attending ANC at KNRH. Women below 35 years of age and those with primary education or less should be specifically targeted when giving health education sessions so as to increase their awareness of GDM.

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Barriers for detection and management of gestational diabetes mellitus in southern Ethiopia: A qualitative study

Cited by 8 publications

References 14 publications

Perinatal asphyxia and associated factors among neonates admitted to a specialized public hospital in South Central Ethiopia: A retrospective cross-sectional study

Perinatal asphyxia and associated factors among neonates admitted to a specialized public hospital in South Central Ethiopia: A retrospective cross-sectional study

A Mixed Methods Multicenter Study on the Capabilities, Barriers, and Opportunities for Diabetes Screening and Management in the Public Health System of Southern Ethiopia

Level of and factors associated with awareness of gestational diabetes mellitus among pregnant women attending antenatal care at Kawempe National Referral Hospital: a cross sectional study

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