Ntlogeleng M Mogale, Thembelihle S Ntuli, Paul K Chelule
{"title":"初级卫生保健机构有效管理2型糖尿病的障碍","authors":"Ntlogeleng M Mogale, Thembelihle S Ntuli, Paul K Chelule","doi":"10.4102/jphia.v16i1.1420","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>In 2024, type 2 diabetes mellitus (T2DM) - a public health challenge - affected 589 million adults worldwide. In South Africa, the prevalence is estimated at 15%, contributing to approximately 3.4 million deaths. Achieving optimal glycaemic control in patients is challenging, resulting in preventable complications and deaths. Systemic reforms and targeted interventions are urgently required.</p><p><strong>Aim: </strong>To identify barriers faced by healthcare professionals (HCPs) to effectively manage patients with T2DM.</p><p><strong>Setting: </strong>A survey was conducted in the Tshwane Metropolitan Municipality, Gauteng province, South Africa.</p><p><strong>Methods: </strong>The study involved 205 HCPs across 22 clinics and 6 community health centres from May 2022 to June 2022. Data were analysed descriptively. Categorical variables were compared using Fisher's exact test and a <i>p</i>-value of < 0.05 was considered significant.</p><p><strong>Results: </strong>Most participants were nurses (84%), < 50 years (65%), female (87%), black people (64.7%), and > 10 years experience (65%) and had academic and in-house training on T2DM (38.5%). Key barriers faced by HCPs in managing patients with T2DM included workload making it difficult monitor patients (53%) and screen for complications (57%), time pressures to deliver quality care (59%) and educate patients (69%), inadequate insulin initiation knowledge (68%) and lack of continuity of care (62%).</p><p><strong>Conclusion: </strong>Excessive workloads, insufficient staffing, time pressures, insulin inertia, and knowledge gaps - impede the delivery of personalised care, patient education and monitoring.</p><p><strong>Contribution: </strong>Addressing these challenges will require collaborative care models, workforce optimisation, targeted training, better resource allocation and health technology and can significantly improve patient outcomes and alleviate burden among HCPs.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"16 1","pages":"1420"},"PeriodicalIF":0.8000,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505870/pdf/","citationCount":"0","resultStr":"{\"title\":\"Barriers to effective management of type 2 diabetes mellitus in primary healthcare facilities.\",\"authors\":\"Ntlogeleng M Mogale, Thembelihle S Ntuli, Paul K Chelule\",\"doi\":\"10.4102/jphia.v16i1.1420\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>In 2024, type 2 diabetes mellitus (T2DM) - a public health challenge - affected 589 million adults worldwide. In South Africa, the prevalence is estimated at 15%, contributing to approximately 3.4 million deaths. Achieving optimal glycaemic control in patients is challenging, resulting in preventable complications and deaths. Systemic reforms and targeted interventions are urgently required.</p><p><strong>Aim: </strong>To identify barriers faced by healthcare professionals (HCPs) to effectively manage patients with T2DM.</p><p><strong>Setting: </strong>A survey was conducted in the Tshwane Metropolitan Municipality, Gauteng province, South Africa.</p><p><strong>Methods: </strong>The study involved 205 HCPs across 22 clinics and 6 community health centres from May 2022 to June 2022. Data were analysed descriptively. Categorical variables were compared using Fisher's exact test and a <i>p</i>-value of < 0.05 was considered significant.</p><p><strong>Results: </strong>Most participants were nurses (84%), < 50 years (65%), female (87%), black people (64.7%), and > 10 years experience (65%) and had academic and in-house training on T2DM (38.5%). Key barriers faced by HCPs in managing patients with T2DM included workload making it difficult monitor patients (53%) and screen for complications (57%), time pressures to deliver quality care (59%) and educate patients (69%), inadequate insulin initiation knowledge (68%) and lack of continuity of care (62%).</p><p><strong>Conclusion: </strong>Excessive workloads, insufficient staffing, time pressures, insulin inertia, and knowledge gaps - impede the delivery of personalised care, patient education and monitoring.</p><p><strong>Contribution: </strong>Addressing these challenges will require collaborative care models, workforce optimisation, targeted training, better resource allocation and health technology and can significantly improve patient outcomes and alleviate burden among HCPs.</p>\",\"PeriodicalId\":44723,\"journal\":{\"name\":\"Journal of Public Health in Africa\",\"volume\":\"16 1\",\"pages\":\"1420\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2025-09-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505870/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Public Health in Africa\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4102/jphia.v16i1.1420\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Public Health in Africa","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4102/jphia.v16i1.1420","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Barriers to effective management of type 2 diabetes mellitus in primary healthcare facilities.
Background: In 2024, type 2 diabetes mellitus (T2DM) - a public health challenge - affected 589 million adults worldwide. In South Africa, the prevalence is estimated at 15%, contributing to approximately 3.4 million deaths. Achieving optimal glycaemic control in patients is challenging, resulting in preventable complications and deaths. Systemic reforms and targeted interventions are urgently required.
Aim: To identify barriers faced by healthcare professionals (HCPs) to effectively manage patients with T2DM.
Setting: A survey was conducted in the Tshwane Metropolitan Municipality, Gauteng province, South Africa.
Methods: The study involved 205 HCPs across 22 clinics and 6 community health centres from May 2022 to June 2022. Data were analysed descriptively. Categorical variables were compared using Fisher's exact test and a p-value of < 0.05 was considered significant.
Results: Most participants were nurses (84%), < 50 years (65%), female (87%), black people (64.7%), and > 10 years experience (65%) and had academic and in-house training on T2DM (38.5%). Key barriers faced by HCPs in managing patients with T2DM included workload making it difficult monitor patients (53%) and screen for complications (57%), time pressures to deliver quality care (59%) and educate patients (69%), inadequate insulin initiation knowledge (68%) and lack of continuity of care (62%).
Conclusion: Excessive workloads, insufficient staffing, time pressures, insulin inertia, and knowledge gaps - impede the delivery of personalised care, patient education and monitoring.
Contribution: Addressing these challenges will require collaborative care models, workforce optimisation, targeted training, better resource allocation and health technology and can significantly improve patient outcomes and alleviate burden among HCPs.
期刊介绍:
The Journal of Public Health in Africa (JPHiA) is a peer-reviewed, academic journal that focuses on health issues in the African continent. The journal editors seek high quality original articles on public health related issues, reviews, comments and more. The aim of the journal is to move public health discourse from the background to the forefront. The success of Africa’s struggle against disease depends on public health approaches.