Integrating Gestational Diabetes Screening and Care and Type 2 Diabetes Mellitus Prevention After GDM Into Community Based Primary Health Care in South Africa-Mixed Method Study.
| Autor: | MUTABAZI, JEAN CLAUDE, BONONG, PASCAL ROLAND ENOK, TROTTIER, HELEN, WARE, LISA JAYNE, NORRIS, SHANE, MURPHY, KATHERINE, LEVITT, NAOMI, ZAROWSKY, CHRISTINA |
|---|---|
| Předmět: |
FOCUS groups
HEALTH services accessibility RESEARCH methodology MEDICAL screening INTERVIEWING QUANTITATIVE research TYPE 2 diabetes PRIMARY health care SOCIOECONOMIC factors CONCEPTUAL structures QUALITATIVE research RISK assessment DESCRIPTIVE statistics QUESTIONNAIRES HEALTH behavior GESTATIONAL diabetes THEMATIC analysis CONTENT analysis POSTNATAL care BEHAVIOR modification |
| Zdroj: | International Journal of Integrated Care (IJIC); Jul-Sep2022, Vol. 22 Issue 3, p1-19, 19p |
| Abstrakt: | Background: Despite high gestational diabetes mellitus (GDM) prevalence in South Africa (9.1% in 2018), its screening and management are not well integrated into routine primary health care and poorly linked to post-GDM prevention of type 2 diabetes mellitus (T2DM) in South Africa's fragmented health system. This study explored women's, health care providers' and experts' experiences and perspectives on current and potential integration of GDM screening and prevention of T2DM post-GDM within routine, community-based primary health care (PHC) services in South Africa. Methods: This study drew on the Behaviour Change Wheel (BCW) framework and used a mixed method, sequential exploratory design for data collection, analysis and interpretation. Individual semi-structured interviews were conducted with key informants (n = 5) from both national and provincial levels and health care providers (n = 18) in the public health system of the Western Cape Province. Additionally, focus group discussions (FGDs) with Community Health Workers (CHWs n = 15) working with clinics in the Western Cape province. A further four FGDs and brief individual exit interviews were conducted with women with GDM (n = 35) followed-up at a tertiary hospital: Groote Schuur Hospital (GSH). Data collection with women diagnosed and treated for GDM happened between March and August 2018. Thematic analysis was the primary analytical method with some content analysis as appropriate. Statistical analysis of quantitative data from the 35 exit interview questionnaires was conducted, and correlation with qualitative variables assessed using Cramér's V coefficient. Results: Shortage of trained staff, ill-equipped clinics, socio-economic barriers and lack of knowledge were the major reported barriers to successful integration of GDM screening and postnatal T2DM prevention. Only 43% of women reported receiving advice about all four recommendations to improve GDM and decrease T2DM risk (improve diet, reduce sugar intake, physical exercise and regularly take medication). All participants supported integrating services within routine, community-based PHC to universally screen for GDM and to prevent or delay development of T2DM after GDM. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
| Externí odkaz: |
|