Exploring the perceptions, practices and challenges of gestational diabetes detection and management among health care providers in a district of Bangladesh

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.