Perspectives of healthcare workers on factors influencing diabetes management and diabetic foot problems in Zimbabwe

Keywords: Africa, diabetes mellitus, diabetic foot, footcare, Zimbabwe

Abstract

Background: Poor management of diabetes mellitus gives rise to complications such as diabetic foot (DF), which pose a host of medical and socioeconomic problems, especially in low-income countries where resources, capacity and awareness are limited.

Aim: This study purposed to identify local factors influencing poor management of diabetes and, therefore, increasing risk of DF in Zimbabwe.

Method: This study utilised a descriptive qualitative design with a purposive sample of 30 nurses from 14 polyclinics and 2 major referral hospitals in Harare, Zimbabwe. Four focus-group discussions were conducted following a semi-structured interview guide with sections addressing commonly encountered socio-economic, cultural and behavioural factors, which potentially increase the risk of DF complications among diagnosed and undiagnosed diabetic individuals. Thematic analysis was used to analyse the data.

Results: Four major themes were identified including poor socioeconomic status, poor self-care, religious and cultural factors, and health-system-related factors. Lack of awareness results in poor health-seeking behaviour, and use of unconventional treatment methods, which may increase DF risk among people living with diabetes, both diagnosed and undiagnosed.

Conclusion: Appropriately tailored education and awareness interventions taking into account local socio-economic and cultural factors are key to the prevention of DF and promotion of self-management activities.

The full article is available at https://doi.org/10.1080/16089677.2020.1817283

Author Biographies

O Kuguyo, University of Zimbabwe

Department of Clinical Pharmacology, University of Zimbabwe, Harare, Zimbabwe

C Muhaso, University of Zimbabwe

Department of Clinical Pharmacology, University of Zimbabwe, Harare, Zimbabwe

S Nyandoro, University of Zimbabwe

Department of Clinical Pharmacology, University of Zimbabwe, Harare, Zimbabwe

J Chirenda, University of Zimbabwe

Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe

V Chikwasha, University of Zimbabwe

Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe

A C Mageza, Parirenyatwa Group of Hospitals

Department of Surgery, Parirenyatwa Group of Hospitals, Harare, Zimbabwe

L Gwanzura, University of Zimbabwe

Department of Medical Laboratory Science, University of Zimbabwe, Harare, Zimbabwe

D M Mukona, University of Zimbabwe

Department of Nursing Science, University of Zimbabwe, Harare, Zimbabwe

A Matimba, University of Zimbabwe

Department of Clinical Pharmacology, University of Zimbabwe, Harare, Zimbabwe

Published
2020-12-01
Section
Original Research