The Challenges of Providing Diabetes Education in Resource-Limited Settings to Women With Diabetes in Pregnancy: Perspectives of an Educator

Goldschmidt, Virginia J; Colletta, Betty

doi:10.2337/diaspect.29.2.101

Cited by 7 publications

(8 citation statements)

References 6 publications

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“…In service trainings in diabetes in pregnancy can be done to equip staff with up to date knowledge that benefits patients." (Female,29)  Lack of collaboration among health care professionals All participants cited that collaboration was lacking among the health care professionals. Management is mainly done by the obstetrician and gynaecolo-gists and the midwives.…”

Section:  Financial Barriersmentioning

confidence: 99%

“…Scans and other specialized tests required should be heavily subsidized so that patients have access to them." (Female,29)  Strengthening health education All participants mentioned that health education facilitates adherence to antidiabetic therapy. Some of the emerging themes were education about diabetes in pregnancy to enhance understanding of the need for stricter blood glucose control in pregnancy, knowledge of signs and symptoms of complications, and knowledge of the importance of adherence to therapy.…”

Section: Facilitators Of Adherence To Anti-diabetic Therapymentioning

confidence: 99%

“…Addressing a patient's financial barriers builds rapport with her and demonstrates understanding of the health care provider of what she will be facing [27].  Lack of health education Challenges in delivering gestational diabetes care and education in low-resource settings include among other challenges the potential for lower literacy and health literacy levels [29]. Lack of health education was also cited under barriers to adherence to anti-diabetic therapy.…”

Section:  Financial Barriersmentioning

confidence: 99%

“…This ensures that every aspect of management is addressed including adherence to therapy." (Female,29) "We must adopt a multi-disciplinary approach in the care of women with diabetes. This ensures that most if not all the needs of our patients are met.…”

Section:  Financial Barriersmentioning

confidence: 99%

“…Emphasize the importance of preventing adverse outcomes of uncontrolled blood sugar, making necessary lifestyle changes and adhering to the treatment regimen to reduce or prevent complications and improve outcomes [27]. Health education for women with diabetes should focus on pathophysiology of GDM, performing SMBG and explaining the need for strict diet adherence with the ultimate goal of controlling blood glucose, allowing for appropriate weight gain, and avoiding complications for both mother and baby [29].  Shortage of staff and lack of trained staff Shortage of trained health care providers is a main barrier within the health system [28].…”

Section:  Financial Barriersmentioning

confidence: 99%

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Barriers and Facilitators of Adherence to Anti-Diabetic Therapy in Pregnant Women with Diabetes: Health Care Workers’ Perspectives

Mukona¹,

Munjanja²,

Zvinavashe³

et al. 2017

JDM

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Global prevalence of hyperglycaemia in pregnancy in women of 20 -49 years was estimated to be 16.9% and affecting 21.4 million live births, in 2013, 90% of which occurred in developing countries. The cornerstone of anti-diabetic therapy is diet, physical activity and medications. The study utilized a qualitative descriptive design using key informant interviews from August 2016 to November 2016 to explore challenges of adherence to anti-diabetic therapy in pregnant women with diabetes at a central hospital in Harare, Zimbabwe. Permission to conduct the study was obtained from the respective local and national ethical review boards. All participants gave verbal and written informed consent. A sample of eight key informants directly involved in the care of pregnant women with diabetes was purposively selected for key informant interviews. Key informants should have worked with diabetic pregnant women for at least one year. Sample size was determined by data saturation. Interviews followed a semi structured questionnaire that had sections on the burden of diabetes in pregnancy, challenges of adherence, challenges in management and possible solutions to challenges faced. All interviews were conducted in a private room. Detailed notes were taken during the interviews which were also being audiotaped. Trustworthiness was achieved by observing credibility, dependability, transferability and confirmability. Thematic analysis was done. Thematic analysis was done manually. The stages of data analysis followed were data organization, familiarization, transcription, coding, developing a thematic framework, indexing, displaying and reporting. Major themes identified were barriers and facilitators of adherence to anti-diabetic therapy. Categories under barriers were financial barriers, lack of health edu- 161cation, lack of trained personnel, shortage of staff and lack of collaboration among practitioners. Categories under facilitators of adherence were subsidization of care, formal training of professionals, promoting collaboration and establishment of a unit dedicated to the care of pregnant women with diabetes. Barriers and solutions identified should be utilized to develop frameworks to promote adherence to anti-diabetic therapy incidence of adverse perinatal outcomes.

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Section:  Financial Barriersmentioning

confidence: 99%

Section: Facilitators Of Adherence To Anti-diabetic Therapymentioning

confidence: 99%

Section:  Financial Barriersmentioning

confidence: 99%

Section:  Financial Barriersmentioning

confidence: 99%

Section:  Financial Barriersmentioning

confidence: 99%

See 3 more Smart Citations

Barriers and Facilitators of Adherence to Anti-Diabetic Therapy in Pregnant Women with Diabetes: Health Care Workers’ Perspectives

Mukona¹,

Munjanja²,

Zvinavashe³

et al. 2017

JDM

View full text Add to dashboard Cite

show abstract

Emerging and Public Health Challenges Existing in Gestational Diabetes Mellitus and Diabetes in Pregnancy

Ana

Shriyan

Deepa

et al. 2021

Endocrinology and Metabolism Clinics of North America

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Barriers to screening, diagnosis and management of hyperglycaemia in pregnancy in Africa: a systematic review

Hinneh

Jahn

Agbozo

2021

International Health

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Gestational diabetes mellitus (GDM) complicates pregnancies in Africa. Addressing the burden is contingent on early detection and management practices. This review aimed at identifying the barriers to diagnosing and managing GDM in Africa. We searched PUBMED, Web of Science, WHOLIS, Google Scholar, CINAHL and PsycINFO databases in May 2020 for studies that reported barriers to diagnosis and management of hyperglycaemia in pregnancy. We used a mixed method quality appraisal tool to assess the quality and risk of bias of the included studies. We adopted an integrated and narrative synthesis approach in the analysis and reporting. Of 548 articles identified, 14 met the eligibility criteria. Health system-related barriers to GDM management were the shortage of healthcare providers, relevant logistics, inadequate knowledge and skills, as well as limited opportunities for in-service training. Patient-related barriers were insufficient knowledge about GDM, limited support from families and health providers and acceptability of the diagnostic tests. Societal level barriers were concomitant use of consulting traditional healers, customs and taboos on food and body image perception. It was concluded that constraints to GDM detection and management are multidimensional. Targeted interventions must address these barriers from broader, systemic and social perspectives.

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The Challenges of Providing Diabetes Education in Resource-Limited Settings to Women With Diabetes in Pregnancy: Perspectives of an Educator

Cited by 7 publications

References 6 publications

Barriers and Facilitators of Adherence to Anti-Diabetic Therapy in Pregnant Women with Diabetes: Health Care Workers’ Perspectives

Barriers and Facilitators of Adherence to Anti-Diabetic Therapy in Pregnant Women with Diabetes: Health Care Workers’ Perspectives

Emerging and Public Health Challenges Existing in Gestational Diabetes Mellitus and Diabetes in Pregnancy

Barriers to screening, diagnosis and management of hyperglycaemia in pregnancy in Africa: a systematic review

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