A A Assayed1, A S Muula2, M J Nyirenda3. 1. Albaraka Charity Trust, Mama Kadija Clinic, Mangochi, Malawi. 2. Department of Community Health, College of Medicine, University of Malawi, Blantyre Malawi. 3. Department of Medicine, College of Medicine, University of Malawi, Blantyre, Malawi ; Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Abstract
BACKGROUND: Diabetes mellitus is a global public health problem. In Malawi, the prevalence of diabetes is 5.6% but the quality of care has not been well studied. OBJECTIVE: The aim of this study was to assess the quality of care offered to diabetic patients in Mangochi district. METHODS: This was a cross sectional descriptive study. Quantitative data were collected using a questionnaire from a sample of 75 diabetic patients (children and adults) who attended the Diabetes Clinic at Mangochi District Hospital between 20012 and 2013. Qualitative data were also collected using semi-structured interviews with eight Key Informants from among the District Health Management Team. Frequencies and cross-tabulation were obtained from the quantitative data. Patients' master cards were checked to validate results. Clinical knowledge about diabetes, care practices and resources were the themes analysed from the qualitative data. RESULTS: Among the 75 participants interviewed, 46 were females and 29 males. The overall mean age was 48.3 years (45.6 for females and 53.3 for males). More than half of patients had little or no information about diabetes (40.0 % (n=30) and 22.7 (n=17) respectively. The majority of patients were taking their medicines regularly 98.7% (n=74). Only 17.3% (n=13) reported having their feet inspected regularly. Fifty-six percent of patients were satisfied about services provision. Some nurses and clinicians were trained on diabetes care but most of them left. Guidelines on diabetes management were not accessible. There were shortages in medicines (e.g. soluble insulin) and reagents. Information Education and Communication messages were offered through discussions, experiences sharing and posters. CONCLUSION: Quality of diabetes care provided to diabetic patients attended to Mangochi hospital was sub-optimal due to lack of knowledge among patients and clinicians and resources. More efforts are needed towards retention of trained staff, provision of pharmaceutical and laboratory resources and health education.
BACKGROUND:Diabetes mellitus is a global public health problem. In Malawi, the prevalence of diabetes is 5.6% but the quality of care has not been well studied. OBJECTIVE: The aim of this study was to assess the quality of care offered to diabeticpatients in Mangochi district. METHODS: This was a cross sectional descriptive study. Quantitative data were collected using a questionnaire from a sample of 75 diabeticpatients (children and adults) who attended the Diabetes Clinic at Mangochi District Hospital between 20012 and 2013. Qualitative data were also collected using semi-structured interviews with eight Key Informants from among the District Health Management Team. Frequencies and cross-tabulation were obtained from the quantitative data. Patients' master cards were checked to validate results. Clinical knowledge about diabetes, care practices and resources were the themes analysed from the qualitative data. RESULTS: Among the 75 participants interviewed, 46 were females and 29 males. The overall mean age was 48.3 years (45.6 for females and 53.3 for males). More than half of patients had little or no information about diabetes (40.0 % (n=30) and 22.7 (n=17) respectively. The majority of patients were taking their medicines regularly 98.7% (n=74). Only 17.3% (n=13) reported having their feet inspected regularly. Fifty-six percent of patients were satisfied about services provision. Some nurses and clinicians were trained on diabetes care but most of them left. Guidelines on diabetes management were not accessible. There were shortages in medicines (e.g. soluble insulin) and reagents. Information Education and Communication messages were offered through discussions, experiences sharing and posters. CONCLUSION: Quality of diabetes care provided to diabeticpatients attended to Mangochi hospital was sub-optimal due to lack of knowledge among patients and clinicians and resources. More efforts are needed towards retention of trained staff, provision of pharmaceutical and laboratory resources and health education.
Authors: J J Gagliardino; P Aschner; S H Baik; J Chan; J M Chantelot; H Ilkova; A Ramachandran Journal: Diabetes Metab Date: 2011-10-22 Impact factor: 6.041
Authors: Niklaus D Labhardt; Jean-Richard Balo; Mama Ndam; Engelbert Manga; Beat Stoll Journal: Trop Med Int Health Date: 2011-07-06 Impact factor: 2.622
Authors: Danielle B Cohen; Theresa J Allain; Simon Glover; Daniel Chimbayo; Helen Dzamalala; Helma W C Hofland; Ndaziona P K Banda; Eduard E Zijlstra Journal: Am J Trop Med Hyg Date: 2010-09 Impact factor: 2.345
Authors: Tara W Strine; Catherine A Okoro; Daniel P Chapman; Gloria L A Beckles; Lina Balluz; Ali H Mokdad Journal: Prev Med Date: 2004-11-19 Impact factor: 4.018
Authors: Kelias P Msyamboza; Bagrey Ngwira; Titha Dzowela; Chimwemwe Mvula; Damson Kathyola; Anthony D Harries; Cameron Bowie Journal: PLoS One Date: 2011-05-23 Impact factor: 3.240
Authors: Victor Singano; Joep J van Oosterhout; Austrida Gondwe; Pearson Nkhoma; Fabian Cataldo; Emmanuel Singogo; Joe Theu; Wilson Ching'ani; Mina C Hosseinpour; Alemayehu Amberbir Journal: Int Health Date: 2021-02-24 Impact factor: 2.473
Authors: Colin Pfaff; Gift Malamula; Gabriel Kamowatimwa; Jo Theu; Theresa J Allain; Alemayehu Amberbir; Sunganani Kwilasi; Saulos Nyirenda; Martias Joshua; Jane Mallewa; Clement Mandala; Joep J van Oosterhout; Monique van Lettow Journal: Malawi Med J Date: 2021-09 Impact factor: 0.875
Authors: C Bamuya; J C Correia; E M Brady; D Beran; D Harrington; A Damasceno; A M Crampin; Ana Magaia; Naomi Levitt; M J Davies; M Hadjiconstantinou Journal: BMC Public Health Date: 2021-07-08 Impact factor: 3.295