Abstract
BackgroundPrompt access to appropriate treatment reduces early onset of complications to chronic illnesses. Our objective was to document the health providers that patients with diabetes in rural areas seek treatment from before reaching hospitals.MethodsPatients attending diabetic clinics in two hospitals of Iganga and Bugiri in rural Eastern Uganda were asked the health providers they went to for treatment before they started attending the diabetic clinics at these hospitals. An exploratory sequential data analysis was used to evaluate the sequential pattern of the types of providers whom patients went to and how they transitioned from one type of provider to another.ResultsOut of 496 patients assessed, 248 (50.0%) went first to hospitals, 104 (21.0%) to private clinics, 73 (14.7%) to health centres, 44 (8.9%) to drug shops and 27 (5.4%) to other types of providers like community health workers, neighbours and traditional healers. However, a total of 295 (59.5%) went to a second provider, 99 (20.0%) to a third, 32 (6.5%) to a fourth and 15 (3.0%) to a fifth before being enrolled in the hospitals’ diabetic clinics. Although community health workers, drug shops and household neighbours were utilized by 65 (13.1%) patients for treatment first, nobody went to these as a second provider. Instead patients went to hospitals, private clinics and health centres with very few patients going to herbalists. There is no clear pathway from one type of provider to another.ConclusionsPatients consult many types of providers before appropriate medical care is received. Communities need to be sensitized on seeking care early from hospitals. Health centres and private clinics need to be equipped to manage diabetes or at least diagnose it and refer patients to hospitals early enough since some patients go to these health centres first for treatment.
Highlights
Prompt access to appropriate treatment reduces early onset of complications to chronic illnesses
In 2016, the prevalence of Diabetes Mellitus from a national survey in Uganda was estimated at 1.4% and was higher in urban areas 2.6% compared to rural areas 1.0% [1]
When people get sick in Iganga and Bugiri districts, they have different types of providers to go to; hospitals, health centres, private clinics, drug shops, Community Health Workers (CHWs), herbalists, neighbours or friends, or others like preachers and pastors
Summary
Prompt access to appropriate treatment reduces early onset of complications to chronic illnesses. Our objective was to document the health providers that patients with diabetes in rural areas seek treatment from before reaching hospitals. In 2016, the prevalence of Diabetes Mellitus from a national survey in Uganda was estimated at 1.4% and was higher in urban areas 2.6% compared to rural areas 1.0% [1]. A national survey in Tunisia showed an increase in diabetes in both urban and rural areas [3]. With the high burden of communicable diseases and a very low physician to patient ratio, primary health facilities in sub-Saharan Africa find it difficult to cope with the demanding care for non-communicable diseases [7]. With an increasing prevalence of diabetes mellitus and low availability of appropriate medications, patients with diabetes could take long to reach the few hospitals that provide care on a regular basis
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