Hypertension and diabetes patients' perspective of challenges and their coping mechanisms in Mukono and Buikwe districts in Uganda - a qualitative study

Rawlance Ndejjo; Paineto Masengere; Fred Nuwaha; Isaac Ddumba; Hilde Bastiaens; Rhoda K Wanyenze; Geofrey Musinguzi

doi:10.12688/openreseurope.13286.2

Hypertension and diabetes patients' perspective of challenges and their coping mechanisms in Mukono and Buikwe districts in Uganda - a qualitative study

Open Res Eur. 2023 Sep 22:1:30. doi: 10.12688/openreseurope.13286.2. eCollection 2021.

Authors

Rawlance Ndejjo¹, Paineto Masengere¹, Fred Nuwaha¹, Isaac Ddumba², Hilde Bastiaens³, Rhoda K Wanyenze¹, Geofrey Musinguzi^{1

3}

Affiliations

¹ Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.
² Department of Health, Mukono District Local Government, Mukono, Uganda.
³ Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium.

Abstract

Background: In sub-Saharan Africa, the burden of non-communicable diseases is steadily rising amidst a high prevalence of communicable diseases stretching the healthcare system. This study explored hypertension and diabetes patients' perspective of challenges and their coping mechanisms in Mukono and Buikwe districts in Uganda. Methods: This descriptive qualitative study involved four focus group discussions with 26 patients at four selected health facilities. All interviews were audio recorded, transcribed verbatim and data analysed following the thematic content analysis guided by the semantic approach with the aid of Atlas ti 6.0.15 software. Results: Five themes were identified regarding challenges and coping mechanisms of patients in managing their conditions. 1) Inadequate opportunities for diagnosis, with community screening supporting identification of patients. 2) Accessing care came amidst transport challenges, absence of health workers and the lack of essential supplies for monitoring conditions. Patients borrowed transport funds or trekked to health facilities and some formed groups to contribute resources to buy equipment and supplies. 3) Access to medications was affected by frequent drug stockouts at public health facilities which pushed patients to purchase own drugs or obtain these through friends and networks. However, other patients resorted to cheaper herbal remedies. 4) Monitoring and managing conditions was affected by insufficient knowledge and opportunities for self-monitoring. Information from health workers and experiences from peers bridged the knowledge gap while private facilities or community health workers supported self-monitoring. 5) Adopting changes in behaviour was challenging but patients fitted these within their usual routines and mobilised family members to also adopt lifestyle changes while ignoring those they deemed unrealistic. Conclusions: The coping mechanisms patients adopted to manage their chronic conditions reflects self-care initiatives at the individual and community levels which could be reinforced and supplemented to better support and empower patients as steps are taken to address existing challenges.

Keywords: Uganda; challenges; coping mechanisms; diabetes; hypertension; lifestyle; self-monitoring.

Associated data

figshare/10.6084/m9.figshare.14213873.v1

Grants and funding

This research was financially supported by the European Union’s Horizon 2020 research and innovation programme under the grant agreement No 733356 (project SPICES). The SPICES project received funding to implement and evaluate a comprehensive CVD prevention program in five settings: a rural & semi-urban community in a low-income country (Uganda), middle income (South Africa) and vulnerable groups in three high-income countries (Belgium, France and United Kingdom). The contents of this article are the views of the authors alone and do not represent the views of the European Union.