TY - JOUR
T1 - Health care professionals’ perspectives on screening and management of gestational diabetes mellitus in public hospitals of South India – a qualitative study
AU - Sahu, Biswamitra
AU - Babu, Giridhara R.
AU - Gurav, Kaveri Siddappa
AU - Karthik, Maithili
AU - Ravi, Deepa
AU - Lobo, Eunice
AU - John, Daisy Abu
AU - Oakley, Laura
AU - Oteng-Ntim, Eugene
AU - Nadal, Iliatha Papachristou
AU - Kinra, Sanjay
N1 - Funding Information:
We sincerely thank the Department of Health and Family Welfare, Government of Karnataka (DHFW, GoK) and The Bruhat Bengaluru Mahanagara Palike (BBMP) for permitting us to conduct the study and constant support. We thank hospitals under DHFW, GoK, Superintendents, Medical Officers, obstetricians, and all the support staff of the department for the support in the on-going study. Our sincere thanks to Dr. Suresh Shapeti and Mr. T.S. Ramesh for facilitating the administrative support and coordination. We thank all the research team members of the GUIDES study for their support in carrying out research activities in the field. We thank all participants for their participation in the on-going study.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/2/12
Y1 - 2021/2/12
N2 - Background: Women developing Gestational Diabetes Mellitus (GDM) are subsequently at a higher risk of developing Type 2 Diabetes later in life. Screening and effective management of women with GDM are essential in preventing progression to type 2 diabetes mellitus. We aimed to explore the perspectives of healthcare providers regarding the barriers from the health system context that restrict the timely screening and effective management of GDM. Methods: We conducted six in-depth interviews of health care providers- four with nurses and two with obstetricians in the public hospitals in India’s major city (Bengaluru). The interviews were conducted in the preferred language of the participants (Kannada for nurses, English for the obstetricians) and audio-recorded. All Kannada interviews were transcribed and translated into English for analysis. The primary data were analyzed using the grounded theory approach by NVivo 12 plus. The findings are put into perspective using the socio-ecological model. Results: Health care providers identified delayed visits to public hospitals and stress on household-level responsibilities as barriers at the individual level for GDM screening. Also, migration of pregnant women to their natal homes during first pregnancy is a cultural barrier in addition to health system barriers such as unmet nurse training needs, long waiting hours, uneven power dynamics, lack of follow-up, resource scarcity, and lack of supportive oversight. The barriers for GDM management included non-reporting women to follow - up visits, irregular self-monitoring of drug and blood sugar, trained staff shortage, ineffective tracking, and lack of standardized protocol. Conclusion: There is a pressing need to develop and improve existing GDM Screening and Management services to tackle the growing burden of GDM in public hospitals of India.
AB - Background: Women developing Gestational Diabetes Mellitus (GDM) are subsequently at a higher risk of developing Type 2 Diabetes later in life. Screening and effective management of women with GDM are essential in preventing progression to type 2 diabetes mellitus. We aimed to explore the perspectives of healthcare providers regarding the barriers from the health system context that restrict the timely screening and effective management of GDM. Methods: We conducted six in-depth interviews of health care providers- four with nurses and two with obstetricians in the public hospitals in India’s major city (Bengaluru). The interviews were conducted in the preferred language of the participants (Kannada for nurses, English for the obstetricians) and audio-recorded. All Kannada interviews were transcribed and translated into English for analysis. The primary data were analyzed using the grounded theory approach by NVivo 12 plus. The findings are put into perspective using the socio-ecological model. Results: Health care providers identified delayed visits to public hospitals and stress on household-level responsibilities as barriers at the individual level for GDM screening. Also, migration of pregnant women to their natal homes during first pregnancy is a cultural barrier in addition to health system barriers such as unmet nurse training needs, long waiting hours, uneven power dynamics, lack of follow-up, resource scarcity, and lack of supportive oversight. The barriers for GDM management included non-reporting women to follow - up visits, irregular self-monitoring of drug and blood sugar, trained staff shortage, ineffective tracking, and lack of standardized protocol. Conclusion: There is a pressing need to develop and improve existing GDM Screening and Management services to tackle the growing burden of GDM in public hospitals of India.
KW - Gestational diabetes mellitus
KW - Health care providers
KW - India
KW - Management
KW - Public sector
KW - Screening
KW - Socio-ecological model
UR - http://www.scopus.com/inward/record.url?scp=85100831152&partnerID=8YFLogxK
U2 - 10.1186/s12913-021-06077-0
DO - 10.1186/s12913-021-06077-0
M3 - Article
AN - SCOPUS:85100831152
SN - 1472-6963
VL - 21
JO - BMC Health Services Research
JF - BMC Health Services Research
IS - 1
M1 - 133
ER -
