Exploring Cultural Influences of Self-Management of Diabetes in Coastal Kenya

Abstract

In spite of increasing prevalence of diabetes among Kenyans and evidence suggesting Kenyans with diabetes maintain poor glycemic control, no one has examined the role of cultural attitudes, beliefs, and practices in their self-management of diabetes. The purpose of this ethnographic study was to describe diabetes self-management among the Swahili of coastal Kenya, and explore factors that affect diabetes self-management within the context of Swahili culture. Thirty men and women with type 2 diabetes from Lamu town, Kenya, participated in this study. Diabetes self-management was insufficiently practiced, and participants had limited understanding of diabetes. Economic factors such as poverty and the high cost of biomedical care appear to have more influence in self-management behavior than socio-cultural and educational factors do. Economic and socio-cultural influences on diabetes self-management should not be underestimated, especially in a limited resource environment like coastal Kenya, where biomedical care is not accessible or affordable to all.

Social Cultural and Economic Factors Affecting the Practice of Secondary Prevention among Patients with Type 2 Diabetes Mellitus at Consolata Nkubu and Meru Level Five Hospital in Meru County

“…In Lamu town, ritual obligations observed especially while attending wedding ceremonies which last for weeks affect the management of diabetes. These occasions affected dietary restrictions of the diabetic patients [28]. The results in this study revealed that in this era, some patients still belief in herbal remedies for treatment and management of diabetes, these results concur with those found in a study in South Asia.…”

Effect of Using Mobile Phone Communication on Morbidity and Health Seeking Behavior of Type 2 Diabetes Mellitus Patients at Kitui County Referral Hospital, Kenya

“…Our study noted that there was no significant effect of the mobile phone intervention on respondents monitoring their feet health. This is similar to results of another study that that showed only 37% of diabetes patients monitored their feet [29]. Another study reported an even lower proportion of 20% of diabetes patients that monitored their feet while a study in Lamu, Kenya, showed that 37% checked their feet regularly.…”

“…Most of respondents in this study were married. This is consistent with another study in Coastal Kenya where 77% of the respondents were married and another in Tripoli, Libya where 76.9% were married [29,30]. However the results are lower than a study in India on T2DM where 98.7% of the respondents were married while another study in Ethiopia on T2DM patients showed 65.1% as married [31,32].…”

A systematic review of adherence to diabetes self‐care behaviours: Evidence from low‐ and middle‐income countries

“…Huang et al () reported a mean foot care practice score of 77.47% among Chinese persons with diabetes (higher scores indicate better self‐perceived overall foot care). Three studies (Abdulrehman, ; Baumann et al, ; Desalu et al, ) reported on regular feet inspection from which rates ranging from 37%–41% were reported. The study by Desalu et al (), investigated a wide range of foot care practices including feet inspection, washing of feet with warm water and inspection of the inside of footwear.…”

“…Although the adherence rates for medication taking are higher than those for the other self‐care behaviours in this review, the wide variations among the studies and between the lowest and highest estimates show that many diabetes patients do not regularly adhere to their anti‐diabetic medications in LMICs. Adherence to anti‐diabetic medications may be more challenging for diabetes patients from LMICs due to a myriad of factors including lack of health insurance, poor‐income levels and lack of medicines, among others (Abdulrehman, ; Aikins, ).…”