"For someone who's rich, it's not a problem". Insights from Tanzania on diabetes health-seeking and medical pluralism among Dar es Salaam's urban poor

Marie Kolling,Mette Von Deden,Kirsty Winkley

doi:10.1186/1744-8603-6-8

Marie Kolling, Mette Von Deden + Show 1 more

Open Access

https://doi.org/10.1186/1744-8603-6-8

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Abstract

The prevalence of chronic non-communicable disease, such as type 2 diabetes mellitus (T2DM), is rising worldwide. In Africa, T2DM is primarily affecting those living in urban areas and increasingly affecting the poor. Diabetes management among urban poor is an area of research that has received little attention. Based on ethnographic fieldwork in Dar es Salam, the causes and conditions for diabetes management in Tanzania have been examined. In this paper, we focus on the structural context of diabetes services in Tanzania; the current status of biomedical and ethnomedical health care; and health-seeking among people with T2DM. We demonstrate that although Tanzania is actively developing its diabetes services, many people with diabetes and low socioeconomic status are unable to engage continuously in treatment. There are many challenges to be addressed to support people accessing diabetes health care services and improve diabetes management.

Highlights

Diabetes affects approximately 246 million people worldwide[1] and has become a major threat to global public health[2]
The structural context of biomedical and ethnomedical health care for people with diabetes in Tanzania Recently, a network of diabetes clinics had been established throughout Tanzania which had provided approximately 100,000 people access to affordable diabetes treatment and health education
These diabetes clinics had been established by the Tanzania Diabetes Association in collaboration with the Tanzanian Ministry of Health (MoH) and other partners and were run by district, regional, and referral hospitals

Summary

Introduction

Diabetes affects approximately 246 million people worldwide[1] and has become a major threat to global public health[2]. Incidence of T2DM has gone from among the lowest in the world to an estimated 909,600 out of Tanzania's approximately 41 million people and prevalence is expected to increase by 50% within the 20 years[3,4]. Diabetes is known to be more common in some African countries rather than others, notably in Northern and Southern African nations, and within countries levels are higher in urban areas compared with rural areas, which is the case of Tanzania[5]. Incidence is increasing in low and middle-income nations and increasing among the poor[1,6], matching what has long been known; that low socioeconomic status equals poor health[7]

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