IJCM_115A: Assessing control status of diabetes and hypertension in adults in rural Nagpur: A Formative Approach

Abstract

Background: Formative research is the process by which researchers aim to understand the current behaviours, perceptions and needs of the target population which affects their decisions and actions. There is gap in literature regarding the health system preparedness to tackle the increasing burden of lifestyle diseases, especially in post-COVID era. This study proposes to identify the various barriers and facilitators in optimising control status among those already diagnosed with lifestyle diseases, through formative approach. Objective: To describe the various barriers and facilitators important for maintaining optimum control of blood sugar and blood pressure among adults with diabetes and hypertension in rural Nagpur Methodology: Rural Nagpur (Populations served by RHTC Bela) Population: 1-Stakeholders including adult consenting diabetic and hypertensive patients. 2-Private and Govt. Medical Practitioner Sampling Technique: Purposive sampling of diabetic and Hypertensive patients was done based on their vocal and willingness to participate in Barrier Analysis. All health care providers from public health facilities (Medical officers and Community health officers from the selected PHC) were considered for in-depth interviews without any sampling. Data collection: Ethnographic analysis including Barrier Analysis through-semi- structured interview, free-listing and Pile sorting using standard techniques. Verbatim recording was followed by coding and analysis. Data Analysis: Analysis was done using Atlas. Ti and Anthropac Software. Smiths Saliency Score was generated wherever appropriate and cognitive map was created. Results: From interim analysis, through triangulation of data, some of the themes that emerged were “Frequent Refill”, “Healthcare Worker Reluctanc”, “Unavailability of medications” as the top barriers to maintaining good control status of diabetes and hypertension. Conclusion: This study will identify the barriers and facilitators at individual, family and at the health system level in controlling the lifestyle diseases, paving the way for the development of future implementation packages appropriate in the cultural context.