Healthcare-seeking behaviour and management of type 2 diabetes in Uganda : Perspectives of persons with diabetes, traditional healers and healthcare providers

Healthcare-seeking behaviour is important as it determines acceptance ofhealthcare and outcomes of chronic conditions, but it has been investigated to alimited extent, and not in developing countries. The overall aim was to explorehow persons with type 2 diabetes seek care to manage diabetes using differenthealthcare providers including the use of complementary alternative medicine andtraditional healers in Uganda. The study design was a combination of quantitativeand qualitative studies to explore and describe healthcare-seeking behaviour. Thethesis included 41 persons with type 2 diabetes, 16 traditional healers, and 108healthcare professionals. Individual semi-structured interviews, focus groupinterviews and self-administered questionnaires were used to collect data. Datawere analysed using qualitative content analysis, qualitative data analysis of focusgroup interviews and descriptive statistics of quantitative data.The preference health service provider for people with diabetes was identified asthe professional health sector. Healthcare was mainly sought, or perceived to besought, among doctors and nurses in the public hospitals. Perceived failure inhealthcare to manage diabetes or its complications led many, particularly women,to seek alternative treatment from complementary alternative medicinepractitioners. Reasons why persons with diabetes switched between differenthealthcare providers were symptoms of diabetes or complications related to poorglycemic control. Patients who sought alternative medicine reported to have beentired of taking western medicine as their condition did not improve or they hopedfor cure. Traditional therapies of patients with diabetes were mainly described asherbal medicine, nutritional products of local fruits and vegetables. Healthcareorganization, treatments costs, patients’ health beliefs, and general conditionseemed to have influenced healthcare-seeking practices.In conclusion, the pattern of care seeking was inconsistent, with a switch betweendifferent healthcare providers under the influence of the popular and folk sectors.Healthcare providers need to develop a well-designed package of diabetes andself-care management education designed to raise awareness about diabetes care atall levels. Nurses and other health professionals need to carry out a comprehensivehealth assessment to identify individuals’ educational needs in order to provideappropriate educational and clinical support, in well-organized diabetes care, tomaintain good health