Diabetes care in a complex humanitarian emergency setting: a qualitative evaluation

Area of Science:

• Public Health
• Endocrinology
• Global Health

Background:

• Increasing burden of diabetes mellitus (DM) necessitates evidence from complex emergency settings.
• Qualitative study of an Integrated Diabetic Clinic within an Outpatient Department (IDC-OPD) in the Democratic Republic of Congo (DRC).

Purpose of the Study:

• To explore patient and provider perspectives on the IDC-OPD model.
• To identify factors supporting or impeding the DM healthcare model in a complex emergency.

Main Methods:

• Qualitative study using focus group discussions (FGDs) and semi-structured interviews.
• Purposive sampling of patients and staff to ensure diverse representation.
• Inductive thematic analysis of coded data.

Main Results:

• Low community awareness of DM leads to delayed presentation and disbelief.
• Patients face challenges with adherence due to unaffordability/unavailability of recommended diets.
• Group psycho-social and sensitization activities facilitate mutual support for treatment adherence.

Conclusions:

• Enhancing community awareness of DM is vital.
• Treatment support, including psychosocial, educational, and culturally sensitive dietary advice, is essential for DM management.
• The IDC-OPD model shows potential but requires adaptation to local contexts for successful adoption and maintenance.