scholarly journals Perceptions of diabetes in rural areas of Eastern Uganda

Curationis ◽  
2013 ◽  
Vol 36 (1) ◽  
Author(s):  
Elizeus Rutebemberwa ◽  
Sheila K. Katureebe ◽  
Sheba N. Gitta ◽  
Amos D. Mwaka ◽  
Lynn Atuyambe

Background: People diagnosed with diabetes mellitus are increasing in sub-Saharan Africa and prompt care seeking depends on perceptions of the illness. Objective: The objective was to explore perceptions of diabetes in rural areas. Method: We conducted a qualitative, explorative and descriptive study in rural eastern Uganda. Eight focus group discussions with community members were conducted. Community members were presented with a story about a person with diabetes symptoms and their perceptions of the diagnosis and treatment elicited. Four focus group discussions with people with diabetes and seven key informant interviews with health workers were conducted. Respondents were asked how the community interpreted symptoms of diabetes, its causes and whether it was curable. Manifest content analysis was used. Results: Some respondents thought people with diabetes symptoms had HIV or were bewitched. Causes of diabetes mentioned included consuming too much fatty food. Some respondents thought diabetes is transmitted through air, sharing utensils with or sitting close to people with diabetes. Some respondents thought that diabetes could heal fast whilst others thought it was incurable. Conclusion: Misdiagnosis may cause delay in seeking proper care. Preventive programmes could build on people’s thinking that too much fatty food causes diabetes to promote diets with less fat. The perception of diabetes as a contagious disease leads to stigmatisation and affects treatment seeking. Seeing diabetes as curable could create patient expectations that may not be fulfilled in the management of diabetes. Rural communities would benefit from campaigns creating awareness of prevention, symptoms, diagnosis and management of diabetes.

2019 ◽  
Author(s):  
Oluwaseun Akinyemi ◽  
Bronwyn Harris ◽  
Mary Kawonga

AbstractObjectivesTo explore how sociocultural factors may support or impede the adoption of community-based distribution of injectable contraceptives in Nigeria.DesignA qualitative study based on a grounded theory approach was conducted through in-depth interviews and focus group discussions.SettingMost participants lived in Gombe State, North East Nigeria. Other participants were from Ibadan (South West) and Abuja (Federal capital territory).ParticipantsThrough seven key informant interviews, 15 in-depth interviews and 10 focus group discussions, 102 participants were involved in the study.MethodsThis study, conducted in 2016 was part of a larger study on scale up of community-based distribution of injectable contraceptives. Qualitative data were collected from traditional and religious leaders, health workers and community members. The data were audio recorded, transcribed and analysed using a thematic framework method.ResultsSociocultural challenges to scale up included patriarchy and men’s fear of losing control over their spouses, traditional and religious beliefs about fertility, and myths about contraceptives and family planning. As a result of deep-rooted beliefs that children are ‘divine blessings’ and that procreation should not be regulated, participants described a subtle resistance to uptake of injectable contraceptives. Since Gombe is largely a patriarchal society, male involvement emerged as important to the success of meaningful innovation uptake. Community leaders largely described their participation in the scale up process as active, although they also identified scope for further involvement and recognition.ConclusionScale up is more than setting up health sector implementing structures, training health workers and getting innovation supplies, but also requires preparedness which includes paying attention to complex contextual issues. This requires the health system and those who work in it, to move beyond a narrow health ‘comfort zone’ by actively engaging with, and learning from, those who are leading, caring for and living in, the community.Strengths and limitations of this studyThe study participants represented a range of stakeholders - users of injectable contraceptives, community members, providers and health system managers.Our results highlighted that scale up is influenced by several socio-cultural factors; thus, showing the importance of paying attention to complex contextual issues during innovation uptake.The findings of our study emphasized how health systems and communities should interact in order to ensure successful scale up of health innovations.As with any qualitative study, the findings of this study are not statistically generalizable.FundingThis research was supported by the Consortium for Advanced Research Training in Africa (CARTA). CARTA is jointly led by the African Population and Health Research Center and the University of the Witwatersrand and funded by the Carnegie Corporation of New York (Grant No--B 8606.R02), Sida (Grant No:54100113), the DELTAS Africa Initiative (Grant No: 107768/Z/15/Z) and Deutscher Akademischer Austauschdienst (DAAD). The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)’s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa’s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust (UK) and the UK government. The statements made and views expressed are solely the responsibility of the authors.Declarations of interestNone.


BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e035449 ◽  
Author(s):  
Gabriella Watson ◽  
Kaajal Patel ◽  
Daly Leng ◽  
Dary Vanna ◽  
Sophanou Khut ◽  
...  

ObjectivesNeonatal mortality remains persistently high in low-income and middle-income countries. In Cambodia, there is a paucity of data on the perception of neonatal health and care-seeking behaviours at the community level. This study aimed to identify influencers of neonatal health and healthcare-seeking behaviour in a rural Cambodian province.DesignA qualitative study using focus group discussions and thematic content analysis.SettingFour health centres in a rural province of Northern Cambodia.ParticipantsTwenty-four focus group discussions were conducted with 85 community health workers in 2019.ResultsCommunity health workers recognised an improvement in neonatal health over time. Key influencers to neonatal health were identified as knowledge, sociocultural behaviours, finances and transport, provision of care and healthcare engagement. Most influencers acted as both barriers and facilitators, with the exception of finances and transport that only acted as a barrier, and healthcare engagement that acted as a facilitator.ConclusionUnderstanding health influencers and care-seeking behaviours is recognised to facilitate appropriate community health programmes. Key influencers and care-seeking behaviours have been identified from rural Cambodia adding to the current literature. Where facilitators have already been established, they should be used as building blocks for continued change.


BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e042690
Author(s):  
Bansari Shah ◽  
Nandita Krishnan ◽  
Stephen R. Kodish ◽  
Gayane Yenokyan ◽  
Kaniz Fatema ◽  
...  

ObjectivesThe Three Delays Model has been commonly used to understand and prevent maternal mortality but has not been systematically applied to emergency medical conditions more generally. The objective of this study was to identify delays in emergency medical care seeking and delivery in rural Bangladesh and factors contributing to these delays by using the Three Delays Model as a framework.DesignA qualitative approach was used. Data were collected through focus group discussions and in-depth interviews using semistructured guides. Two analysts jointly developed a codebook iteratively and conducted a thematic analysis to triangulate results.SettingSix unions in Raiganj subdistrict of Bangladesh.ParticipantsEight focus group discussions with community members (n=59) and eight in-depth interviews with healthcare providers.ResultsDelays in the decision to seek care and timely receipt of care on reaching a health facility were most prominent. The main factors influencing care-seeking decisions included ability to recognise symptoms and decision-making power. Staff and resource shortages and lack of training contributed to delays in receiving care. Delay in reaching care was not perceived as a salient barrier. Both community members and healthcare providers expressed interest in receiving training to improve management of emergency conditions.ConclusionsThe Three Delays Model is a practical framework that can be useful for understanding barriers to emergency care and developing more tailored interventions. In rural Bangladesh, training community members and healthcare providers to recognise symptoms and manage acute conditions can reduce delays in care seeking and receiving adequate care at health facilities.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Meghan A. Potasse ◽  
Sanni Yaya

Abstract Background There are many barriers that impact a woman’s access to contraception in rural sub-Saharan Africa, such as financial constraints, supply shortages, stigma, and misconceptions. Through and African Feminist lens, this study examines how these perceived barriers intersect with each other, and how they negatively impact women’s access to family planning and their perceived value of contraceptives in Luweero, Uganda. Methods This qualitative study analyzed data collected from healthcare workers at one private clinic and one public clinic that offer family planning services in four focus group discussions in Luweero, Central Region, Uganda. Two focus group discussions were held in each clinic. Eligible participants spoke English, were at least 18 years of age, and had at least 3 years of experience as a healthcare worker in Luweero. Among the participants were nurses, midwives, family planning counsellors, and village health workers, both male and female. Coded transcripts were analyzed using a reflexive methodology through an African Feminist lens. Results Most of the responses indicated that financial constraints experienced either by the clinic or the women significantly impact access to family planning. Certain social barriers were discussed, and the participants explained that barriers such as stigma, misconceptions, lack of knowledge, religiosity and cultural values impact women’s motivation or ability to access contraceptive methods. Side effects also have a significant role to play in women’s ability or motivation to navigate through these perceived social barriers. Conclusions Participants determined that increased funding for transportation for village health teams, consistent funding for free contraception, and expanded sensitization efforts that particularly target men would be some of the most impactful methods they can adapt to address some of these barriers.


2021 ◽  
Vol 15 (1) ◽  
pp. e0009031
Author(s):  
Anna Tiny van’t Noordende ◽  
Suchitra Lisam ◽  
Panca Ruthindartri ◽  
Atif Sadiq ◽  
Vivek Singh ◽  
...  

Background Understanding how knowledge, attitudes and practices regarding leprosy differ in endemic countries can help us develop targeted educational and behavioural change interventions. This study aimed to examine the differences and commonalities in and determinants of knowledge, attitudes, practices and fears regarding leprosy in endemic districts in India and Indonesia. Principle findings A cross-sectional mixed-methods design was used. Persons affected by leprosy, their close contacts, community members and health workers were included. Through interview-administered questionnaires we assessed knowledge, attitudes, practices and fears with the KAP measure, EMIC-CSS and SDS. In addition, semi-structured interviews and focus group discussions were conducted. The quantitative data were analysed using stepwise multivariate regression. Determinants of knowledge and stigma that were examined included age, gender, participant type, education, occupation, knowing someone affected by leprosy and district. The qualitative data were analysed using open, inductive coding and content analysis. We administered questionnaires to 2344 participants (46% from India, 54% from Indonesia) as an interview. In addition, 110 participants were interviewed in-depth and 60 participants were included in focus group discussions. Knowledge levels were low in both countries: 88% of the participants in India and 90% of the participants in Indonesia had inadequate knowledge of leprosy. In both countries, cause, mode of transmission, early symptoms and contagiousness of leprosy was least known, and treatment and treatability of leprosy was best known. In both countries, health workers had the highest leprosy knowledge levels and community members the highest stigma levels (a mean score of up to 17.4 on the EMIC-CSS and 9.1 on the SDS). Data from the interviews indicated that people were afraid of being infected by leprosy. Local beliefs and misconceptions differed, for instance that leprosy is in the family for seven generations (Indonesia) or that leprosy is a result of karma (India). The determinants of leprosy knowledge and stigma explained 10–29% of the variability in level of knowledge and 3–10% of the variability in level of stigma. Conclusion Our findings show the importance of investigating the perceptions regarding leprosy prior to educational interventions in communities: even though knowledge levels were similar, local beliefs and misconceptions differed per setting. The potential determinants we included in our study explained very little of the variability in level of knowledge and stigma and should be explored further. Detailed knowledge of local knowledge gaps, beliefs and fears can help tailor health education to local circumstances.


2016 ◽  
Vol 25 (1) ◽  
Author(s):  
Salmah Lao Manalocon- Basher

Female circumcision refers to the procedures that intentionally alter or cause injury to the female external genital organs. The reasons for doing this vary but it is commonly observed in places where Muslims predominate. The study is intended to determine: 1) the rate of females who had undergone female circumcision in Madrasah School compared to those who went to English schools, 2) the prevalence rate of female circumcision among Meranaos, and 3) the practices and experiences of women who have undergone FC. The study utilized a combination of quantitative and qualitative methods using a designed questionnaire, interview and focus group discussions with the respondents. The results showed that more girls who were studying in Madrasah have undergone this practice compared to the number of girls who are in Western or English schools. It also showed that the prevalence rate of this practice is indeed high in the rural areas, which is 86%. The practice of FC is performed either during Fridays, Holidays or Mondays and Thursdays. Each mentioned day has meanings and there are certain procedures and instructions being followed in doing the practice. In conclusion, religious justification remains the strong reason why FC is still rampantly performed in the different rural areas of Lanao del Sur, Philippines.


Author(s):  
Irene Korkoi Aboh ◽  
Busisiwe P. Ncama

Introduction: There is evidence of the inability of older people in Nigeria, Ghana and other developing countries to sustain themselves through savings, assets or pensions. This situation highlights the minimal benefit of pensions, savings or assets as income sources for older people; old age very often brings poverty and disability. Methodology: A qualitative interpretive design informed the study. The study area was categorized into three distinct ecological areas namely urban, periurban and rural areas. Twenty interviews and three focus group discussions with 68 elderly persons were conducted in ten sub-districts in the Cape Coast Metropolis, Ghana. The forty-eight elderly individuals were put into groups of 8, 20 and 20 for the focus group discussions. Data was thematically analysed.Results: Four major themes and subthemes were identified to reflect the pertinent issue of exploring and defining the preparedness of people for their retirement and ageing. There was evidence that preparing for old age is not an active precedent for the people of Cape Coast and they still believe in the traditional system of caring where it is the sole responsibility of the family to care for its own aged members.Conclusion: It is evident that formal care is not practiced in Ghana and that the aged therefore find the idea bewildering. They want to experience this care, but existing norms expect the family members to single-handedly provide care for their aged.


2019 ◽  
Vol 8 (2) ◽  
pp. 73-80
Author(s):  
Cau Kim Jiu ◽  
Somporn Rungreangkulkij

The condition of families with autistic children raises many views and judgments both from family and society. This ethnographic study aimed to describe the meaning of families and communities towards families with autistic children. Data were collected through focus group discussions and in-depth interviews. Key informants come from families who have autistic children and community members recruited by purposive sampling, while the data were analyzed using thematic analysis. This study results generate  two categories of perception of the meaning of having autistic children.  The first category was made by the families which comprises four themes such as 1) A test from God, 2) Destiny of God, 3) Autistic children different with other children, and 4) Children who need intensive helping. The second category was the perception made by the community members which consists of two themes, such as 1) Test for family, and 2) An autistic child as a holy child. This study further shows that  culture is believed to determine how families and the members of the community perceive and interpret the existence of autistic children in the families so that it is very important for health workers to understand the culture that exists in the community.


Author(s):  
Woubishet Girma ◽  
Dessalegn Tamiru ◽  
Mirkuzie Woldie ◽  
Ayantu Kebede ◽  
Zewdie Birhanu ◽  
...  

Background Establishing maternity waiting homes is a key strategy to address the geographic barrier to obstetric care access among women living in rural areas. In Ethiopia, maternity waiting homes have been in use for several years, with a sharp increase in the number of such facilities recently. However, there is little empirical evidence detailing the experiences and challenges faced by women during the implementation of this initiative in Ethiopia. Methods This study used a multiple case study design with qualitative data collection methods, and was conducted from October to November 2016. Data were collected using focus group discussions, in-depth interviews and direct observation of each maternity waiting home. All interviews and focus group discussions were recorded using a digital voice recorder. Data were transcribed and translated into English. The coding process and formation of thematic structure was assisted by Atlas ti7.5 computer software. Results The participants reported that they were satisfied and comfortable with the services at the maternity waiting homes, as were their husbands and community leaders. Facility, social and environmental challenges were identified as common barriers to the utilisation of maternity waiting homes by stakeholders at different levels. Healthcare providers reported common challenges at maternity waiting homes include a lack of basic utilities (water and electric supply), and overcrowding because of a shortage of space and lack of medical supplies. Some women reported that poor transportation services and the distance to facilities hindered the utilisation of maternity waiting homes. Conclusions There are social and facility challenges related to the use of maternity waiting homes in Ethiopia. Policymakers and health managers should work with relevant sectors to mitigate the effect of facility, social and environmental barriers and maximise the use of maternity waiting homes.


BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e025516 ◽  
Author(s):  
Zelee Hill ◽  
Yared Amare ◽  
Pauline Scheelbeek ◽  
Joanna Schellenberg

ObjectivesTo understand the recent rise in facility deliveries in Ethiopia.DesignA qualitative study.SettingFour rural communities in two regions of Ethiopia.Participants12 narrative, 12 in-depth interviews and four focus group discussions with recently delivered women; and four focus group discussions with each of grandmothers, fathers and community health workers.ResultsWe found that several interwoven factors led to the increase in facility deliveries, and that respondents reported that the importance of these factors varied over time. The initial catalysts were a saturation of messages around facility delivery, improved accessibility of facilities, the prohibition of traditional birth attendants, and elders having less influence on deciding the place of delivery. Once women started to deliver in facilities, the drivers of the behaviour changed as women had positive experiences. As more women began delivering in facilities, families shared positive experiences of the facilities, leading to others deciding to deliver in a facility.ConclusionOur findings highlight the need to employ strategies that act at multiple levels, and that both push and pull families to health facilities.


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