Annals of Global Health (Aug 2021)

Social Support for Self-Care: Patient Strategies for Managing Diabetes and Hypertension in Rural Uganda

  • Andrew K. Tusubira,
  • Christine K. Nalwadda,
  • Ann R. Akiteng,
  • Evelyn Hsieh,
  • Christine Ngaruiya,
  • Tracy L. Rabin,
  • Anne Katahoire,
  • Nicola L. Hawley,
  • Robert Kalyesubula,
  • Isaac Ssinabulya,
  • Jeremy I. Schwartz,
  • Mari Armstrong-Hough

DOI
https://doi.org/10.5334/aogh.3308
Journal volume & issue
Vol. 87, no. 1

Abstract

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Background: Low-income countries suffer a growing burden of non-communicable diseases (NCDs). Self-care practices are crucial for successfully managing NCDs to prevent complications. However, little is known about how patients practice self-care in resource-limited settings. Objective: We sought to understand self-care efforts and their facilitators among patients with diabetes and hypertension in rural Uganda. Methods: Between April and June 2019, we conducted a cross-sectional qualitative study among adult patients from outpatient NCD clinics at three health facilities in Uganda. We conducted in-depth interviews exploring self-care practices for hypertension and/or diabetes and used content analysis to identify emergent themes. Results: Nineteen patients participated. Patients said they preferred conventional medicines as their first resort, but often used traditional medicines to mitigate the impact of inconsistent access to prescribed medicines or as a supplement to those medicines. Patients adopted a wide range of vernacular practices to supplement treatment or replace unavailable diagnostic tests, such as tasting urine to gauge blood-sugar level. Finally, patients sought and received both instrumental and emotional support for self-care activities from networks of family and peers. Patients saw their children as their most reliable source of support facilitating self-care, especially as a source of money for medicines, transport and home necessities. Conclusion: Patients valued conventional medicines but engaged in varied self-care practices. They depended upon networks of social support from family and peers to facilitate self-care. Interventions to improve self-care may be more effective if they improve access to prescribed medicines and engage or enhance patients’ social support networks.