ArticleBMC health services research2019
Quality and barriers of outpatient diabetes care in rural health facilities in Uganda - a mixed methods study.
Article in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Non-adherence to self-care and associated factors among diabetes adult population in Ethiopian: A systemic review with meta-analysis.PloS one · 2021Pooled it
- Impact of the COVID-19 pandemic on quality of life of adults with diabetes in rural Uganda: a cross-sectional survey.International health · 2026Article
- Review
- A Scoping Review of Noncommunicable Disease Programs Evaluation: Bridging Gaps and Improving Frameworks in Primary Healthcare.Health science reports · 2026Review
- Models of care for noncommunicable diseases in primary care: key elements and design in low- and middle-income countries - a scoping review.Global health action · 2025Article
- Composite risk of cardiovascular disease comorbidity in people living with diabetes in Africa.Cardiovascular endocrinology & metabolism · 2025Article
- Facilitators and barriers of fruit and vegetable consumption among Ugandans living with diabetes: a qualitative study.BMJ nutrition, prevention & health · 2025Article
- "These are just finishing our medicines": older persons' perceptions and experiences of access to healthcare in public and private health facilities in Uganda.BMC health services research · 2024Article
- Knowledge, attitudes and practices towards glycemic control among persons with diabetes mellitus at two tertiary hospitals in Uganda.African health sciences · 2024Article
- A Systematic Review of the Microbial Landscape of Diabetic Foot Ulcers in Uganda.Infection and drug resistance · 2024Review
- Insulin therapy among diabetic patients in rural communities of Sub-Saharan Africa: a perspective review.Therapeutic advances in endocrinology and metabolism · 2024Review
- The needs of patients with diabetes for the prevention and treatment of foot complications in Thailand: A qualitative descriptive study.Belitung nursing journal · 2023Article
- Effects of Telephone-Based Brief Motivational Interviewing on Self-Management, Medication Adherence, and Glycemic Control in Patients with Uncontrolled Type 2 Diabetes Mellitus in a Rural Community in Thailand.Patient preference and adherence · 2023Article
- Economic Burden of Diabetic Mellitus Among Patients on Follow-up Care in Hospitals of Southwest Shewa Zone, Central Ethiopia.BMC health services research · 2022Article
- Access and Use of Health Services by People with Diabetes from the Item Response Theory.International journal of environmental research and public health · 2022Article
- Process quality of type 2 diabetes mellitus care and association with patient perceived attributes of family doctor service in urban general practices, Beijing, China.BMC primary care · 2022Article
- Non-adherence to medication and associated factors among type 2 diabetes patients at Clinique Medicale Fraternite, Rwanda: a cross-sectional study.BMC endocrine disorders · 2022Article
- Using standardized patients to assess the quality of type 2 diabetes care among primary care providers and the health system: Evidence from rural areas of western China.Frontiers in public health · 2022Article
- Peer support and social networking interventions in diabetes self-management in Kenya and Uganda: A scoping review.PloS one · 2022Article
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Authors and funding
4 authors.
Funding
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Abstract
backgroundDespite the increasing burden of diabetes in Uganda, little is known about the quality of type 2 diabetes mellitus (T2DM) care especially in rural areas. Poor quality of care is a serious limitation to the control of diabetes and its complications. This study assessed the quality of care and barriers to service delivery in two rural districts in Eastern Uganda.
methodsThis was a mixed methods cross-sectional study, conducted in six facilities. A randomly selected sample of 377 people with diabetes was interviewed using a pre-tested interviewer administered questionnaire. Key informant interviews were also conducted with diabetes care providers. Data was collected on health outcomes, processes of care and foundations for high quality health systems. The study included three health outcomes, six elements of competent care under processes and 16 elements of tools/resources and workforce under foundations. Descriptive statistics were computed to determine performance under each domain, and thematic content analysis was used for qualitative data.
resultsThe mean age of participants was 49 years (±11.7 years) with a median duration of diabetes of 4 years (inter-quartile range = 2.7 years). The overall facility readiness score was 73.9%. Inadequacies were found in health worker training in standard diabetes care, availability of medicines, and management systems for services. These were also the key barriers to provision and access to care in addition to lack of affordability. Screening of clients for blood cholesterol and microvascular complications was very low. Regarding outcomes; 56.8% of participants had controlled blood glucose, 49.3% had controlled blood pressure; and 84.0% reported having at least one complication.
conclusionThe quality of T2DM care provided in these rural facilities is sub-optimal, especially the process of care. The consequences include sub-optimal blood glucose and blood pressure control. Improving availability of essential medicines and basic technologies and competence of health workers can improve the care process leading to better outcomes.
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