Health-care seeking behaviour among persons with diabetes in Uganda: an interview study

Katarina Hjelm,Fortunate Atwine

doi:10.1186/1472-698x-11-11

Abstract

BackgroundHealthcare-seeking behaviour in patients with diabetes mellitus (DM) has been investigated to a limited extent, and not in developing countries. Switches between different health sectors may interrupt glycaemic control, affecting health. The aim of the study was to explore healthcare-seeking behaviour, including use of complementary alternative medicine (CAM) and traditional healers, in Ugandans diagnosed with DM. Further, to study whether gender influenced healthcare-seeking behaviour.MethodsThis is a descriptive study with a snowball sample from a community in Uganda. Semi-structured interviews were held with 16 women and 8 men, aged 25-70. Data were analysed by qualitative content analysis.ResultsHealthcare was mainly sought among doctors and nurses in the professional sector because of severe symptoms related to DM and/or glycaemic control. Females more often focused on follow-up of DM and chronic pain in joints, while males described fewer problems. Among those who felt that healthcare had failed, most had turned to traditional healers in the folk sector for prescription of herbs or food supplements, more so in women than men. Males more often turned to private for-profit clinics while females more often used free governmental institutions.ConclusionsHealthcare was mainly sought from nurses and physicians in the professional sector and females used more free-of-charge governmental institutions. Perceived failure in health care to manage DM or related complications led many, particularly women, to seek alternative treatment from CAM practitioners in the folk sector. Living conditions, including healthcare organisation and gender, seemed to influence healthcare seeking, but further studies are needed.

Highlights

Healthcare-seeking behaviour in patients with diabetes mellitus (DM) has been investigated to a limited extent, and not in developing countries
The aim of this study was to explore healthcare-seeking behaviour, including use of complementary alternative medicine and traditional healers in Ugandans diagnosed with DM
Healthcare seeking In all respondents, irrespective of gender, help with health problems was solely sought from the professional sector primarily, mainly from health care staff in public hospital or private for-profit clinics, and in some cases private for-profit nursing homes

Summary

Introduction

Healthcare-seeking behaviour in patients with diabetes mellitus (DM) has been investigated to a limited extent, and not in developing countries. The aim of the study was to explore healthcare-seeking behaviour, including use of complementary alternative medicine (CAM) and traditional healers, in Ugandans diagnosed with DM. Nurses play a key role by acting as a co-ordinator in organising holistic care to meet patients needs based on individual beliefs about health and illness, aimed at teaching patients to become experts on their own disease and self-management. Health services in Uganda are provided by the public and private sector [9]. Services are free of charge with the exception of private wings in public hospitals. The private system includes private not for profit organisations (Catholic, Protestant, Orthodox and Muslim) and private health practitioners which charge user fees. There is a negotiation about the user charge, payment is relatively low and might be made in terms of available items (e.g chicken, goat etc.)

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