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

Background Globally, diabetes affects 537 million individuals aged 20-79, significantly undermining their quality of life and economic stability, with the greatest impact in low- and middle-income countries. This study aims to deepen understanding of the diabetes burden in Ga Mashie, an urban-poor area in Accra, Ghana. Methods We conducted a cluster survey of adults over 25 years in 80 enumeration areas within Ga Mashie, targeting 959 eligible households based on the 2021 census. Household-level data included household membership and structure, water and sanitation, cooking infrastructure, and asset ownership. Individual-level data encompassed demographics, lifestyle behaviours, and biometric measurements. Diabetes was identified through random blood glucose levels ≥11.1 mmol/L or a prior diagnosis, with obesity defined as a body mass index >30 kg/m2 and central obesity as a waist circumference-to-height ratio >0.5. We derived weighted prevalence estimates and compared these estimates by age, sex, and wealth, using unadjusted odds-ratios (OR). Results The survey, achieving a 67% response rate, covered 854 individuals from 644 households. It unveiled a notable prevalence of non-communicable disease risk factors: 47.2% for alcohol consumption (95% CI: 43.7-50.8), 73.3% for insufficient physical activity (95% CI: 69.1-77.1), 28.9% for unhealthy snack consumption (95% CI: 24.5-33.7), 35.1% for obesity (95% CI: 31.3-39.1), and 74.5% for central obesity (95% CI: 70.8-77.9). Diabetes affected 8.2% of the population aged ≥25 (95% CI: 6.4-10.5), with disparities evident across age, wealth, and sex (2.66 greater odds in females for diabetes [95% CI: 1.38-5.12]). Conclusion Diabetes and its risk factors are highly prevalent in Ga Mashie, with significant demographic disparities underscoring the need for targeted interventions. The study highlights the critical challenge diabetes poses in urban-poor contexts, emphasizing the necessity for tailored health initiatives to mitigate this burden.

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Diabetes self-management: a qualitative study of education needs, practices and caregiver support in the Keta Municipality of Ghana

Tetteh,

Saah,

Amu

2024

bmjph

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IntroductionA major part of diabetes management involves patients’ self-management. Poor self-management increases the risk of complications from the condition. Good self-management requires appropriate and adequate education and caregiver support, typically provided through structured diabetes education programmes. Education on various topics, including self-management, is a key component of diabetes management services in Ghana. However, challenges such as limited knowledge, economic constraints and sociocultural factors hinder self-management practices. We explored the self-management education (SME), practice and support needs of adults with type-2 diabetes (T2D) at the Keta Municipal Hospital.Research design and methodsThis phenomenological study involved 16 adults living with T2D and two healthcare providers in the Keta Municipality of Ghana. Data were collected through in-depth and expert interviews using interview guides. Interpretative phenomenological analysis was employed to analyse the data using NVivo V.12.ResultsSME was provided within an hour during the first section of the monthly diabetes clinic covering dietary needs and restrictions, physical exercises, adherence to medication and wound prevention and care. SME needs were individualised SME and extension of education to the general population. The participants practised self-management activities. They attributed their improved practices to both the general group education and the individualised goals and input received during individual counselling sessions. Motivators for self-management were cues from negative health outcomes, wanting to survive the condition for a long time and SME received. Challenges to self-management entailed job roles, insufficient medication dosages and unavailability of medication at the hospital during review visits.ConclusionsThe study suggests that individualised SME and caregiver support may enhance self-management practices and outcomes. This underscores the significance of considering patient-specific factors and support systems when designing effective diabetes management strategies. The provision of comprehensive SME, including group and individual sessions, along with the utilisation of visual aids, can contribute to improved self-management outcomes.

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

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References 35 publications

The status of blood glucose monitoring and its influencing factors in Chinese patients with type 2 diabetes initiating premixed insulin: A prospective real-world study

The status of blood glucose monitoring and its influencing factors in Chinese patients with type 2 diabetes initiating premixed insulin: A prospective real-world study

Prevalence of diabetes and associated risk factors in Ga Mashie, Accra, Ghana – the CARE Diabetes community-based survey

Diabetes self-management: a qualitative study of education needs, practices and caregiver support in the Keta Municipality of Ghana

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