Rural/Urban Variations in Diabetes Self-Care in a Sample of Ghanaian Adults with Type II Diabetes: a Study in the East Gonja Municipality

Abstract

More recently, there has been a greater focus on nutrition and physical activity as key determinants of health. Available evidence suggests that community of residence drive unhealthy diets and sedentary behaviour (e.g. increased physical inactivity); unhealthy diet and sedentary behaviour are major risk factors for non-communicable diseases (NCDs). This single-site hospital-based study assessed rural/urban variations in diabetes self-care practices in a sample of Ghanaian adults with type II diabetes. The study employed a descriptive cross-sectional design. Respondents were recruited from the Diabetes/Hypertension clinic of the East Gonja Municipal Hospital in Salaga, Ghana, through systematic sampling. Structured, interviewer-administered questionnaires were used to collect data for the study. The primary data were analyzed using Statistical Package for Social Sciences (SPSS) version 25. One hundred and sixty-eight (168) type II diabetes patients participated in the study. More than half of them were residents of rural communities (50.6%). Overall, adherence to medication, diet, and physical activity were 51.8%, 41.8%, and 56.0%, respectively. Controlling for age, occupation, and monthly income, residents of urban communities were more likely to adhere to prescribed anti-diabetic medications compared to those in rural communities (AOR 3.70; 95% CI 1.02, 8.11). On the contrary, residence in a rural community was positively associated with adherence to dietary recommendations (AOR 4.21; 95% CI 1.73, 9.54). The current findings highlight the need for diabetes self-management education and support (DSMES) programmes in the East Gonja Municipality to facilitate the knowledge sharing, decision-making, and skills mastery for diabetes self-care.

Self-care behaviors and associated factors among individuals with type 2 diabetes in Ghana: a systematic review

“…The highest optimal proportion of adherence (84.5%) was reported by Afaya et al [23] and the lowest (33.5%) by Kretchy et al [16]. Three studies found optimal adherence to medication to be prevalent in more than half of the participants [8,23,30].…”

“…Further, Mogre et al [27] reported the daily adherence to recommendations on physical activity to be 21.4% among participants. The overall adherence to physical activity reported by Nketia [30] was 41.8%.…”

“…Four studies reported primary results on the extent of adherence to dietary recommendations [22,23,27,30]. Two studies found that on average, individuals with type 2 diabetes adhered to recommended dietary practices about four days a week [23,27].…”

“…Three studies reported data on the extent of adherence to physical activity recommendations among individuals with type 2 diabetes [23,27,30]. One study reported that patients engaged in physical activity for approximately High Amankwah-Poku et al [24]; High Bruce et al [25] Moderate Doglikuu et al [11] High Doglikuu et al [22] High Kretchy et al [6] High Kugbey et al [26] Moderate Mogre et al [27] Moderate Osei-Yeboah et al [8] High Owiredua et al [28] High Sefah et al [29] High Nketia [30] Moderate Prevalence of optimal adherence to physical activity.…”

“…Six of the included studies reported data on the extent of adherence to medication among persons with type 2 diabetes [8,16,23,25,29,30]. These studies reported varying rates of good adherence to medication among the study participants in the range of 33.5-84.5%.…”