PLOS Global Public Health (Jan 2023)

Self-care and healthcare seeking practices among patients with hypertension and diabetes in rural Uganda.

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

DOI
https://doi.org/10.1371/journal.pgph.0001777
Journal volume & issue
Vol. 3, no. 12
p. e0001777

Abstract

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BackgroundImplementing effective self-care practices for non-communicable diseases (NCD) prevents complications and morbidity. However, scanty evidence exists among patients in rural sub-Saharan Africa (SSA). We sought to describe and compare existing self-care practices among patients with hypertension (HTN) and diabetes (DM) in rural Uganda.MethodsBetween April and August 2019, we executed a cross-sectional investigation involving 385 adult patients diagnosed with HTN and/or DM. These participants were systematically randomly selected from three outpatient NCD clinics in the Nakaseke district. Data collection was facilitated using a structured survey that inquired about participants' healthcare-seeking patterns, access to self-care services, education on self-care, medication compliance, and overall health-related quality of life. We utilized Chi-square tests and logistic regression analyses to discern disparities in self-care practices, education, and healthcare-seeking actions based on the patient's conditions.ResultsOf the 385 participants, 39.2% had only DM, 36.9% had only HTN, and 23.9% had both conditions (HTN/DM). Participants with DM or both conditions reported more clinic visits in the past year than those with only HTN (P = 0.005). Similarly, most DM-only and HTN/DM participants monitored their weight monthly, unlike those with only HTN (PConclusionCompared to rural Ugandans with HTN-only, participants with DM had greater utilization of healthcare services, exposure to self-care education, and adherence to medicine and self-monitoring behaviors. These findings should inform ongoing efforts to improve and integrate NCD service delivery in rural SSA.