Peer support and social networking interventions in diabetes self-management in Kenya and Uganda: A scoping review

Abstract

Background Diabetes mellitus is a growing worldwide health challenge especially in sub-Saharan Africa. While the use and effectiveness of diabetes self-management interventions is well documented in high-income countries, little information exists in sub-Saharan Africa. Therefore, this study attempted to synthesize information in the literature on the use and efficacy of peer support and social networking in diabetes self-management in Kenya and Uganda. Objective The purpose of this scoping review is to summarize research on the extent of use and efficacy of peer support and social networking interventions in diabetes self-management in Kenya and Uganda. Design We searched PubMed, ScienceDirect and Cochrane Library databases for articles reporting peer support and social networking interventions in Kenya and Uganda published in English between 2000 and September 2021. Key words encapsulated three major themes: peer support, social networking and self-management. Hand searches were also conducted to select eligible papers. Data was extracted using a form prepared and piloted in line with PRISMA-ScR guidelines. Results Thirteen peer reviewed articles were selected for analysis. Eleven studies reported peer support interventions while two focused on social networks in diabetes self-management. Peer support and social networking interventions incorporated microfinance and group medical visits, diabetes self-management education, telephone support and Medication Adherence Clubs. Most interventions were delivered by multidisciplinary teams comprising nurses and other professionals, peer educators, peer leaders and community health workers. Most interventions were effective and led to improvements in HbA1c and blood pressure, eating behaviors and physical activity and social support. Conclusions The limited studies available show that peer support and social networking interventions have mixed results on health and other outcomes. Importantly, most studies reported significant improvements in clinical outcomes. Further research is needed on the nature and mechanisms through which peer support and social network characteristics affect health outcomes.

Role of community-based health clubs in promoting patients’ health education for diabetes self-care management: an interventional qualitative study in a Ugandan urban setting

“…Although it may be challenging for our current healthcare systems that struggle with staff shortages to assign health workers to every club in case the intervention is adopted, creative approaches like task-shifting could be initiated to fill the gap. Task-shifting of roles from physicians to nurses or lay cadres has for long been applied as an essential component of community-based care 4 15 26. For example, task-shifting from health workers to peers has successfully been employed in the maternal and child health activities and in HIV/AIDS response for community care and has yielded positive results and patient clinical outcomes 4 15.…”

“…Task-shifting of roles from physicians to nurses or lay cadres has for long been applied as an essential component of community-based care 4 15 26. For example, task-shifting from health workers to peers has successfully been employed in the maternal and child health activities and in HIV/AIDS response for community care and has yielded positive results and patient clinical outcomes 4 15. Therefore, in a resource-limited setting, the nurse educator’s (who is also a patient with diabetes) role would be shifted to being a ‘diabetes champion’, who has been trained to help educate and support fellow diabetics.…”

“…This enables patients to actively participate in the management of their disease based on health education and various skills to achieve targets of metabolic control, prevent or delay the onset of acute and chronic complications and thus preserve quality of life 9 12–14. This is associated with improvements in self-care behaviours like diet, foot care, physical activity, coping and stress relief, significant clinical outcomes (glycaemic control) and acceptability of the condition 12 14 15. Although several strategies have been undertaken to improve the management of DM in Uganda, little has been done to empower patients to practise self-care.…”

Supported self-management in long-term conditions in an African context

“… Supported self-management : A process where individuals are actively involved in their disease management (McCorkle et al 2011 ; Richard & Shea 2011 ). Otanga et al ( 2022 ) Kenya and Uganda Primary healthcare, community urban, peri-urban, and rural settings Adults Diabetes Scoping review summarising use and efficacy of peer support and social networking interventions in diabetes self-management. Followed by Levack et al ( 2011 ) and Arksey and O’Malley ( 2005 ).…”

A Quasi-experimental study on the effectiveness of primary caregiver social support capacity on self-management practices of clients living with type II diabetes in Machakos county, Kenya

“…6 In sub-Saharan Africa, for example, self-management is poor due to a lack of culturally relevant knowledge, lack of glucometers, and practice of alternative therapies, including misconceptions that diabetes is a curable disease, often resulting in poor health outcomes and increased burden on the health system. 7 Studies on the impact of primary caregiver social support are limited in Kenya, with the few having been cross-sectional and showing mixed results on health and other outcomes for type 2 diabetes clients. 8 Caregivers can assist patients with chronic disease in selfmanagement and social support to improve decisionmaking on health-related behaviors and overall health outcomes.…”