Health challenges
Primary care management of diabetes in a low/middle income country: a multi-method, qualitative study of barriers and facilitators to care
The avaialbility of medicines severely influences the primary care management of diabetes in Tunisia
Authors:
H. Alberti; N. Boudriga; M. Nabli
Publisher:
BMC Family Practice, 2007
This article from BMC Family Practice looks at factors influencing the primary care management of diabetes in Tunisia, a low/middle-income country with ten per cent prevalence of the disease. The authors surveyed patients, health professionals and organisations for their views.More than 400 factors emerged. Overall, the most commonly cited factor was the availability of medication at the health centre. The main organisational factors were the existence of chronic disease clinics, seen as key to improving care, and doctors’ heavy workload, seen as a barrier. The most commonly mentioned health professional factor was doctors’ motivation, particularly relating to inadequate time spent with patients. Key patient factors included financial constraints, poor attendance and lack of compliance with treatment. Gender was also an important factor, with women accounting for 62 per cent of diabetes patients attending healthcare facilities despite similar prevalence of the disease among men.
The authors suggest that doctors’ motivation appears to be the most important factor which could be improved by intervention, and requires further study. They acknowledge that this may not be possible in settings with more limited resources.However, they conclude that policymakers and practitioners in other developing countries could still usefully apply these findings to improving diabetes care in their own settings.
