Abstract
Background: Type 2 diabetes (T2D) poses a disproportionate burden on Benin, West Africa. However, no diabetes intervention has yet been developed for Benin’s contexts. This study aimed to explore specific cultural beliefs, attitudes, behaviors, and environmental factors to help adapt a diabetes self-management program to patients with T2D from Cotonou, in southern Benin. Methods: Qualitative data were collected through focus group discussions (FDGs) involving 32 patients with T2D, 16 academic partners, and 12 community partners. The FDGs were audio-recorded, transcribed verbatim from French to English, and then analyzed thematically with MAXQDA 2020. Results: Healthy food was challenging to obtain due to costs, seasonality, and distance from markets. Other issues discussed were fruits and vegetables as commodities for the poor, perceptions and stigmas surrounding the disease, and the financial burden of medical equipment and treatment. Information about local food selections and recipes as well as social support, particularly for physical activity, were identified, among other needs. When adapting the curriculum, gender dynamics and spirituality were suggested. Conclusions: The study demonstrates the need for culturally sensitive interventions and a motivation-based approach to health (spiritual and emotional support). It also lays the groundwork for addressing T2D contextually in Benin and similar sub-Saharan African countries.
Highlights
Type 2 diabetes (T2D) is a global epidemic, with 15.9 million adults affected in subSaharan Africa (SSA), causing an annual economic cost of USD 3.3 billion
We proposed to adapt Meta Salud Diabetes (MSD), an evidence-based diabetes self-management education program, to Benin’s context
The population grew by 12% from 2015 to 2018, most of the increase was among adults 45 years of age and older, which is significant since this age group is at a higher risk of T2D [25,26]
Summary
Type 2 diabetes (T2D) is a global epidemic, with 15.9 million adults affected in subSaharan Africa (SSA), causing an annual economic cost of USD 3.3 billion. It is estimated that the burden of T2D on the African continent will increase by approximately. A sub-Saharan country, is no exception as the prevalence of diabetes doubled between 2008 (4.6%) and 2015 (8.4%). The diabetes prevalence reached 21.6%, with 15.1% in urban areas [2]. The burden of T2D is projected to rise in Benin due to accelerated urbanization and a new lifestyle [3]. Diabetes ranks among the 10 most prevalent health conditions that cause disability, with a 55.8% rise in diabetes-related disabilities between 2007 and 2017 [4]. Most diabetes cases in Benin are in secondary health facilities where diabetes educators are scarce. Medical officers often assume these roles, while nurses act as diabetes educators [5]
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