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

Ann Glob Health. 2021 Aug 19;87(1):86. doi: 10.5334/aogh.3308. eCollection 2021.

Abstract

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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Child
  • Cross-Sectional Studies
  • Diabetes Mellitus / ethnology
  • Diabetes Mellitus / therapy*
  • Diet
  • Exercise
  • Female
  • Fruit
  • Humans
  • Hypertension / ethnology
  • Hypertension / therapy*
  • Interviews as Topic
  • Male
  • Medication Adherence
  • Qualitative Research
  • Rural Population
  • Self Care*
  • Social Support
  • Uganda
  • Vegetables