Abstract:The biomedical model of diabetes was a major source of legitimate information for self-care practices. However, this was understood and applied through a complex framework of cultural theories of chronic disease, the biopsychological impact of everyday illness experience and the disempowering effects of poverty. An integrated biopsychosocial approach is proposed for diabetes intervention in this research community.
“…Twenty-one studies included information on healthy eating self-care behaviors. Participants understood that unhealthy eating is a dominant cause of diabetes [ 16 , 22 , 23 ] and that it is important to take aspects such as the sugar-, salt- or fat-level of consumed food into consideration [ 19 , 22 , 24 – 26 ]. However, misconceptions and gaps of knowledge were present; particularly about the definition of high risk food [ 19 ], the sugar-level of food [ 24 , 27 ] and the underlying diabetes related metabolic mechanisms [ 24 ].…”
Section: Resultsmentioning
confidence: 99%
“…The results indicate a very low degree of SMBG, ranging from a study from Uganda, where none of the patients had access to a glucose meter at home [ 41 ] to one study from Nigeria with 43% of all patients doing glucose testing at home [ 40 ]. On average only 15% of all patients were able to test his or her blood glucose level at home [ 23 , 25 , 29 , 31 , 32 , 40 – 47 ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Participants had various levels of knowledge about general consequences and complications of uncontrolled diabetes. All respondents from Ghana attributed complications to medical non-adherence [ 23 ] and most patients from a South African study [ 22 ] connected their already developed complications (e.g. foot problems, sexual dysfunction) to uncontrolled diabetes.…”
Section: Resultsmentioning
confidence: 99%
“…The use of herbal medicines as part of the diabetes treatment was on average 32% [ 21 , 34 , 46 , 48 ]. For some participants, it was grounded on their negative feelings and dissatisfaction towards biomedicine [ 15 ] or the belief that diabetes is a supernatural problem caused by witchcraft or fate [ 23 , 25 , 55 ]. To others, the willingness to treat diabetes took them to a 'modern' health facility but the willingness to cure diabetes took them to a traditional healer [ 15 , 33 , 56 ].…”
BackgroundThe prevalence of diabetes in sub-Saharan Africa has increased rapidly over the last years. Self-management is a key element for the proper management, but strategies are currently lacking in this context. This systematic review aims to describe the level of self-management among persons living with type 2 diabetes mellitus in sub-Saharan Africa.MethodRelevant databases including PubMed, Web of Science and Google Scholar were searched up to September 2016. Studies reporting self-management behavior of people with type 2 diabetes mellitus and living in sub-Saharan Africa were included.ResultsA total of 550 abstracts and 109 full-text articles were assessed. Forty-three studies, mainly observational, met the inclusion criteria. The studies showed that patients rarely self-monitored their glucose levels, had low frequency/duration of physical activity, moderately adhered to recommended dietary and medication behavior, had poor level of knowledge regarding diabetes related complications and sought traditional or herbal medicines beside of their biomedical treatment. The analysis also revealed a lack of studies on psychosocial aspects.ConclusionExcept for the psychosocial area, there is a good amount of recent studies on self-management behavior of type 2 diabetes mellitus sub-Saharan Africa. These studies indicate that self-management in sub-Saharan Africa is poor and therefore a serious threat to the health of individuals and the health systems capacity.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6050-0) contains supplementary material, which is available to authorized users.
“…Twenty-one studies included information on healthy eating self-care behaviors. Participants understood that unhealthy eating is a dominant cause of diabetes [ 16 , 22 , 23 ] and that it is important to take aspects such as the sugar-, salt- or fat-level of consumed food into consideration [ 19 , 22 , 24 – 26 ]. However, misconceptions and gaps of knowledge were present; particularly about the definition of high risk food [ 19 ], the sugar-level of food [ 24 , 27 ] and the underlying diabetes related metabolic mechanisms [ 24 ].…”
Section: Resultsmentioning
confidence: 99%
“…The results indicate a very low degree of SMBG, ranging from a study from Uganda, where none of the patients had access to a glucose meter at home [ 41 ] to one study from Nigeria with 43% of all patients doing glucose testing at home [ 40 ]. On average only 15% of all patients were able to test his or her blood glucose level at home [ 23 , 25 , 29 , 31 , 32 , 40 – 47 ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Participants had various levels of knowledge about general consequences and complications of uncontrolled diabetes. All respondents from Ghana attributed complications to medical non-adherence [ 23 ] and most patients from a South African study [ 22 ] connected their already developed complications (e.g. foot problems, sexual dysfunction) to uncontrolled diabetes.…”
Section: Resultsmentioning
confidence: 99%
“…The use of herbal medicines as part of the diabetes treatment was on average 32% [ 21 , 34 , 46 , 48 ]. For some participants, it was grounded on their negative feelings and dissatisfaction towards biomedicine [ 15 ] or the belief that diabetes is a supernatural problem caused by witchcraft or fate [ 23 , 25 , 55 ]. To others, the willingness to treat diabetes took them to a 'modern' health facility but the willingness to cure diabetes took them to a traditional healer [ 15 , 33 , 56 ].…”
BackgroundThe prevalence of diabetes in sub-Saharan Africa has increased rapidly over the last years. Self-management is a key element for the proper management, but strategies are currently lacking in this context. This systematic review aims to describe the level of self-management among persons living with type 2 diabetes mellitus in sub-Saharan Africa.MethodRelevant databases including PubMed, Web of Science and Google Scholar were searched up to September 2016. Studies reporting self-management behavior of people with type 2 diabetes mellitus and living in sub-Saharan Africa were included.ResultsA total of 550 abstracts and 109 full-text articles were assessed. Forty-three studies, mainly observational, met the inclusion criteria. The studies showed that patients rarely self-monitored their glucose levels, had low frequency/duration of physical activity, moderately adhered to recommended dietary and medication behavior, had poor level of knowledge regarding diabetes related complications and sought traditional or herbal medicines beside of their biomedical treatment. The analysis also revealed a lack of studies on psychosocial aspects.ConclusionExcept for the psychosocial area, there is a good amount of recent studies on self-management behavior of type 2 diabetes mellitus sub-Saharan Africa. These studies indicate that self-management in sub-Saharan Africa is poor and therefore a serious threat to the health of individuals and the health systems capacity.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6050-0) contains supplementary material, which is available to authorized users.
“…There have been considerable efforts by sub-Saharan African (SSA) countries to improve access to primary health care services, partly through the implementation of risk-pooling community or national health insurance schemes (Jowett et al, 2004;Witter & Garshong, 2009;Robyn et al, 2013). Universal health insurance coverage programmes, such as Ghana's National Health Insurance Scheme (NHIS), are vital mechanisms for ensuring equity in access to and use of health care services, via the removal of financial barriers associated with seeking treatment in health care facilities (Bennett, 2004;Agyepong & Adjei, 2008;Blanchet et al, 2012). Community-based and national health insurance schemes also offer additional funds for health care financing (Jowett et al, 2004;Gnawali et al, 2009).…”
Aim:
This paper examined the association between wealth and health insurance status and the use of traditional medicine (TM) among older persons in Ghana.
Background:
There have been considerable efforts by sub-Saharan African countries to improve access to primary health care services, partly through the implementation of risk-pooling community or national health insurance schemes. The use of TM, which is often not covered under these insurance schemes, remains common in many countries, including Ghana. Understanding how health insurance and wealth influence the use of TM, or otherwise, is essential to the development of equitable health care policies.
Methods:
The study used data from the first wave of the World Health Organisation’s Study of Global Ageing and Adult Health conducted in Ghana in 2008. Descriptive statistics and negative loglog regression models were fitted to the data to examine the influence of insurance and wealth status on the use of TM, controlling for theoretically relevant factors.
Findings:
Seniors who had health insurance coverage were also 17% less likely to frequently seek treatment from a TM healer relative to the uninsured. For older persons in the poorest income quintile, the odds of frequently seeking treatment from TM increased by 61% when compared to those in the richest quintile. This figure was 46%, 62% and 40% for older persons in poorer, middle and richer income quintiles, respectively, compared to their counterparts in the richest income quintile.
Conclusion:
The findings indicate that TM was primarily used by the poor and persons who were not enrolled in the National Health Insurance Scheme. TM continues to be a vital health care resource for the poor and uninsured older adults in Ghana.
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