Care-Seeking Dynamics among Patients with Diabetes Mellitus and Hypertension in Selected Rural Settings in Kenya

Abstract

Diabetes mellitus and hypertension are two common non-communicable diseases (NCDs) that often coexist in patients. However, health-seeking behaviour in patients with diabetes mellitus or hypertension has not been extensively studied especially in low- and middle-income countries. This study aimed to examine care-seeking dynamics among participants diagnosed with diabetes and/or hypertension across nine counties in rural Kenya. We conducted a cross-sectional study among adults diagnosed with diabetes and/or hypertension through face-to-face interviews. Of the 1100 participants, 69.9% had hypertension, 15.5% diabetes while 14.7% had both. The mean age of the respondents was 64 years. The majority of the respondents (86%) were on allopathic treatment. Hospital admission, having a good self-rated health status and having social support for illness, were positively associated with appropriate health-seeking behaviour while use of alcohol and pharmacy or chemist as source of treatment were negatively associated with appropriate health-seeking behaviour. Our study found a high prevalence of appropriate health-seeking behaviour among respondents with the majority obtaining care from government facilities. The results are evidence that improving public health care services can promote appropriate health-seeking behaviour for non-communicable diseases and thus improve health outcomes.

Socioeconomic inequalities in hypertension in Kenya: a decomposition analysis of 2015 Kenya STEPwise survey on non-communicable diseases risk factors

“…This could be due to the differences in study population. However, we hypothesize the poorest individuals faces several financial barriers, which hinder access to health services for control and treatment of hypertension [56] due to huge out of pocket expenditure [6,57]. In addition, despite the hypertension screening and early diagnosis being key in averting hypertension, it is likely that individuals in the richest wealth quintile are screened more for high blood pressure than the poorest individuals.…”

Socioeconomic inequalities in hypertension in Kenya: A decomposition analysis of 2015 Kenya STEPwise survey on non-communicable diseases risk factors

“…This could be due to the differences in study population. However, we hypothesize the poorest individuals faces several nancial barriers, which hinder access to health services for control and treatment of hypertension [56] due to huge out of pocket expenditure [6,57]. In addition, despite the hypertension screening and early diagnosis being key in averting hypertension, it is likely that individuals in the richest wealth quintile are screened more for high blood pressure than the poorest individuals.…”

Integrated healthcare services for HIV, diabetes mellitus and hypertension in selected health facilities in Kampala and Wakiso districts, Uganda: A qualitative methods study

“…Other research showed that NCD users in Uganda were found to be unable to afford the cost of care [48] and faced significant geographical constraints to accessing services [49,50]. In South Africa, Malawi, Kenya and Uganda transport difficulties remained a key component not only in the integrated non-communicable diseases care but also for general healthcare access [7,[50][51][52][53][54][55]. We found in our study that even when the number of clinic visits was reduced, some people still struggled to meet the costs of transport to get to their appointments.…”

“…Studies in rural Kenya and South Africa have reported that being dissatisfied with treatment was one of the reasons why hypertensive, diabetic and HIV service users skipped refill appointments [54,61]. Ensuring quality care, is important to acceptability in any type of clinic.…”