Gestational Diabetes: Exploring the Perceptions, Practices and Barriers of the Community and Healthcare Providers in Rural Bangladesh: A Qualitative Study

Animesh Biswas; Koustuv Dalal; Abu Sayeed Md Abdullah; A K M Fazlur Rahman; Abdul Halim

doi:10.2147/DMSO.S238523

Gestational Diabetes: Exploring the Perceptions, Practices and Barriers of the Community and Healthcare Providers in Rural Bangladesh: A Qualitative Study

Diabetes Metab Syndr Obes. 2020 Apr 23:13:1339-1348. doi: 10.2147/DMSO.S238523. eCollection 2020.

Authors

Animesh Biswas¹, Koustuv Dalal², Abu Sayeed Md Abdullah¹, A K M Fazlur Rahman^{3

4}, Abdul Halim^{1

5}

Affiliations

¹ Reproductive and Child Health Department, Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka 1206, Bangladesh.
² Department of Public Health Science, School of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
³ Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka 1206, Bangladesh.
⁴ Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh.
⁵ Kumudini Medical College, Tangail, Bangladesh.

Abstract

Background and objective: Gestational Diabetes Mellitus (GDM) is a prevalent and important disease during pregnancy and has detrimental effects on both the mother and the baby. The current study explored the perception and attitude of the community people about GDM and describes the challenges and gaps in knowledge, availability and accessibility of services for GDM screening and management at a rural community in Bangladesh.

Methods: We performed a qualitative study including seven Focus Group Discussions (FGDs) and eight Key Informant Interviews (KIIs) from November 2017 to January 2018 at randomly selected areas of Tangail district. A highly trained team including two anthropologists conducted the qualitative studies (FGDs and KIIs) under the guidance of experienced researchers. Thematic analysis was performed.

Results: GDM is not a known term for pregnant women, their husbands, mothers, and mothers-in-law. Most of the participants (78.7%) did not even hear the term. Some of them (25.5%) perceived that GDM will persist for whole life and transmit from husband to wife and mother to baby. Some people (21.3%) thought that GDM entirely depends on the wish of the God. Most of the participants (68.1%) perceived that symptoms of other types of diabetes and GDM are almost the same. Some participants (19.1%) thought that GDM patients need to intake some medicines that might affect the fetus. The majority of the respondents (83%) had no idea when a pregnant woman should test her diabetes during pregnancy. If GDM diagnosed, pregnant women decided to follow the advice of the doctors. The results from KII with health managers found that they lack in-depth knowledge of GDM. There is no structured guideline or protocol at their facilities for GDM management.

Conclusion: The existing barriers at the communities for adequate detection and management of GDM are identified properly. The findings of this study will be helpful for the decision-makers in taking necessary actions to control the GDM.

Keywords: Bangladesh; challenges; community; gestational diabetes; practices.

Grants and funding

The community based GDM detection and surveillance in Bangladesh intervention is financially supported by the World Diabetes Foundation (WDF).