Factors associated with utilization of basic diabetes mellitus services among adult diabetic patients at Mbarara Regional Referral Hospital Diabetic Clinic, Uganda

Abstract

Background: Utilization of diabetic care services remains a challenge among adult patients in low and middle-income countries. Proper utilization of diabetic care services could reduce morbidity and mortality, and delay the development of long-term complications associated with diabetes mellitus among these patients. This study assessed the utilization of basic diabetic care services, associated factors and underlying challenges among patients with diabetes mellitus in utilizing basic diabetic care services at the Mbarara Regional Referral Hospital-diabetic clinic. Methods: An explanatory sequential mixed methods design was used. Data were collected between June 2022 and August 2022. Consecutive and purposive sampling was used to select patients with diabetes mellitus for the quantitative and qualitative studies respectively. A total of 208 study participants were interviewed for the quantitative component; 13 In-depth interviews and 5 key informant interviews (KIIs) were conducted for the qualitative part. Quantitative data were entered into the Epidata manager version (V4.6.0.4) and analysed using STATA version 14.0. Modified Poisson regression analysis was used to determine the association between the utilization of basic diabetic services and independent variables. Inductive thematic analysis was used to analyze the qualitative data in open code software. Results: Over a half of the patients with diabetes mellitus (62.0%, 95%CI (55.3 68.7)) utilized basic diabetic care services. Waiting at the diabetic clinic for more than 120 minutes (APR 0.46, 95% CI 0.27 0.80), being of age 45-54 years (APR 1.48, 95% CI (1.11 1.98)), and 55-60 years (APR 1.38, 95% CI (1.02 1.86)) were associated with utilization of basic diabetic care services. Waiting time at the facility for long hours, missing health education sessions, inadequate diabetic care services and high cost of diabetic care were identified as challenges affecting the utilization of basic diabetic care. Conclusion: About a third of the patients did not utilize basic diabetic care services which poses a challenge in the management of diabetic Mellitus. Young diabetic patients should be engaged to improve their utilization of diabetic care services through health education. Interventions should be implemented to reduce the long waiting time of the patients at the health facility. Strategies to ensure low-cost diabetic care services are available for patients should be implemented.