Challenges and needs of people living with diabetes in self-management in Ethiopia: A qualitative exploration

Abstract

Abstract Background Diabetes is unique due to its cross-cutting nature, impacting multiple organ systems and increasing the risk for other communicable and non-communicable diseases if not managed properly. Managing diabetes involves frequent blood glucose measurement, medication management, healthy eating, emotional stability, and staying active. This study aimed to explore the challenges and unmet needs in diabetes self-management among adults living with diabetes in Ethiopia. Methods We conducted one-to-one semi-structured interviews with 21 adults living with diabetes and 5 general practitioner physicians in Addis Ababa, Ethiopia. Interviews were transcribed, translated into English, and analyzed using reflexive thematic analysis with NVIVO. Results Eleven and eight general themes of challenges and needs were identified, respectively. The outstanding challenges were related to emotional well-being, insulin management and supply, access to glucose meter, healthy eating and food insecurity, diabetes education and self-care skills, social stigma and misconceptions, and customized treatment and communication. Needs for awareness creation among the society, customized treatment and involvement in personal treatment plan, better healthcare service, and emotional support system are the identified non-technological needs. Moreover, needs for glucose measuring device, better insulin administration system, complete guiding tool, and mHealth system to aid in diabetes monitoring are the technological needs identified. Conclusion People living with diabetes in Sub-Saharan Africa experience multi-faceted challenges and have many unmet needs. Interventions should be adapted to the region’s unique requirements. Findings highlight priorities for strengthening diabetes self-management education, psychosocial support, and access to essential supplies, while informing context-adapted mHealth functions to complement core service and supply needs.