Abstract
Background: Gestational diabetes mellitus (GDM) is one of key maternal morbidities during pregnancy globally. It is one of the neglected threats during pregnancy that constitutes pregnancy-related complications. Moreover, a significant number of GDM positive women later develop type 2 diabetes after delivery following an interval of 5-10 years. However, the real magnitude of GDM in Bangladesh is still undetermined. The objective of this study was to explore the perceptions, practices and challenges of GDM detection and management among health care providers (HCPs) in the Tangail district of Bangladesh. Methods: A mixed method study was conducted between November 2017 and January 2018. Quantitative data was collected through a survey of providers, whereas qualitative data collection included in-depth interviews with providers and direct observation of 41 health care facilities. Descriptive analysis was performed for quantitative data and qualitative data analysis was performed thematically. Results: The study revealed that 66.6% of HCPs did not know about GDM related complications for affected mothers and their babies, 81.2% did not know about the risk factors of GDM, 95.8% were not aware about the management and/or treatment of GDM, 79.1% never conducted GDM screening of pregnant women and almost none of the interviewees received any special training on GDM. We observed that only 31.3% of women were tested for blood sugar in antenatal care and of those, 12.5% were identified as having elevated blood sugar levels. GDM related information was collected in 4.2% of cases. Conclusions: There is limited knowledge and skills among the HCPs to detect and manage GDM at the community level. More programmatic emphasis is required to strengthen the capacity of community health care workers in detecting and treating GDM.
Highlights
Diabetes in pregnancy is a neglected cause of maternal morbidity, with one in every six pregnancies affected by Gestational diabetes mellitus (GDM) globally[1]
The majority of the respondents who participated in the survey had never heard of diabetes that occurs during pregnancy or gestational diabetes (81%, n=38)
health care providers (HCPs) had no clear perception of GDM and some considered GDM to be the same as diabetes
Summary
Diabetes in pregnancy is a neglected cause of maternal morbidity, with one in every six pregnancies affected by GDM globally[1]. Bangladesh is one of the top ten contributors to diabetes cases globally and this number is expected to double in the 20 years[4]. Gestational diabetes mellitus (GDM) is one of key maternal morbidities during pregnancy globally. It is one of the neglected threats during pregnancy that constitutes pregnancyrelated complications. The objective of this study was to explore the perceptions, practices and challenges of GDM detection and management among health care providers (HCPs) in the Tangail district of Bangladesh.
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