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ABSTRACT: Objectives
Diabetes care remains unavailable and unaffordable for many people. Adapting models of care to low-income and middle-income country contexts is a priority. Digital technology offers substantial potential yet must surmount health system, technological and acceptability issues. This formative research aimed to identify the potential for a digital technology solution (Diabetes Compass) to address diabetes care gaps in primary healthcare.Design
Qualitative research was conducted in selected districts of Sri Lanka and Tanzania with practitioners, patients and family members. In-depth interviews assessed how digital solutions may improve diabetes care, acceptability and usability; contextual and clinical observations identified practitioner clinical competencies, strengths and weaknesses, and the influence of the care environment on service delivery; and workshop discussions explored strategies to encourage digital solution uptake and sustain use.Setting
The research was undertaken in 2022 at nine health facilities in Sri Lanka's Southern Province (Galle), and 16 health facilities in Tanzania's Lindi and Pwani Regions.Participants
Participants included primary and secondary care practitioners, facility managers, patients and family members.Results
There was striking concordance in the diabetes care gaps and potential for digital solutions in the two countries, and between practitioners, patients and family members. Five main gaps were practitioner training; health information systems and data; service delivery; infrastructure, equipment and medication; and community awareness and knowledge. Practitioners, patients and family members saw strong potential for digital solutions to improve early detection, diagnosis, secondary prevention of complications and improve patients' and families' experience of living with diabetes. They identified specific design and implementation considerations to enable the Diabetes Compass to realistically meet these needs and overcome challenges.Conclusion
There was a strong appetite among practitioners, patients and family members for a digital solution to strengthen diabetes care. Their experience of challenges and practical recommendations informed the Diabetes Compass design.
SUBMITTER: Jackson-Morris AM
PROVIDER: S-EPMC11216042 | biostudies-literature | 2024 Jun
REPOSITORIES: biostudies-literature
Jackson-Morris Angela M AM Calopietro Michael J MJ Krishnamurthy Reddiar Sumithra S Kataria Ishu I Ramaiya Kaushik K Sumanathilleke Manilka R MR Wickramasinghe Champika C Salum Bakari B Ubuguyu Omary O Ngilangwa David P DP Shayo Festo K FK Sinnathamby Vijayapala V Sandunika de Silva Appu Hennedi Totahewage Lihini AHTL
BMJ open 20240626 6
<h4>Objectives</h4>Diabetes care remains unavailable and unaffordable for many people. Adapting models of care to low-income and middle-income country contexts is a priority. Digital technology offers substantial potential yet must surmount health system, technological and acceptability issues. This formative research aimed to identify the potential for a digital technology solution (Diabetes Compass) to address diabetes care gaps in primary healthcare.<h4>Design</h4>Qualitative research was con ...[more]