A cross-sectional study of diabetic knowledge in West Bengal, India: an analysis based on access to health care

Abstract

In India, the rising prevalence of diabetes is a major public health challenge. The purpose of this study was to measure the level of diabetes knowledge in West Bengal, India, and to assess for a gradient in knowledge among those with varying levels of access to health care in both urban and rural environments. A validated questionnaire on diabetes knowledge was developed and administered in two health care settings in West Bengal: community clinics in low-income rural and urban communities representing the low-access group and a multi-specialty outpatient department (OPD) in Kolkata, India, representing the high-access group. Of the respondents in the low-access community clinic group, (n = 198), less than half knew what diabetes was (42.9 %) compared to 89.9 % in the high-access OPD group (n = 275) (p < 0.001). Those in the urban community clinics knew what diabetes was more often than those in the rural community clinics (49.5 vs. 36.1 %, p = 0.058). Additional questions testing basic knowledge of diabetes, risk factors, and disease complications showed a similar trend that people in the low-access setting had limited knowledge regarding diabetes and significantly less knowledge when compared to those in the high-access setting. Multivariate regression analysis demonstrated that clinic setting (high-access vs. low-access, p < 0.0001) and formal education (p = 0.001) were independent predictors of diabetic knowledge, while age and sex were not. Diabetes knowledge among respondents with low access to health care in urban and rural community clinics was significantly poorer than those with higher access to health care in an urban hospital outpatient department. To help bridge this gap, diabetes education and prevention campaigns should be targeted towards populations with low access to health care in West Bengal.