Primary Healthcare and diabetes management in the rural communities

Primary health care (PHC) was conceptualized to play a ‘central hub’ role in health systems. Diabetes care services are presently unavailable in PHC facilities, except the screening programs that are carried out by non-governmental organizations. This implies there is issue of behavioural change wheel (BCW) of the stakeholders including the quartet of ministry of health, hospital management board, healthcare professionals (HCP) and diabetes patients. This narrative review investigates perception of stakeholders towards scaling-up of a diabetes context of PHC agenda in Delta State Nigeria. The study utilized data from ongoing studies including opportunistic and purposive sampling designs. Data from published literatures on Nigeria were also reviewed. The various stakeholders’ perceptions is that motivation is poor across board. The ministry of health as well as the hospitals management board, but not patients, have the capacity. Suggested ways of improving BCW in the state include increased allocation for the ministry of health, and retraining healthcare professionals. Others improvement measures including tackling socio-cultural beliefs, and taboos are suggested. Scaling-up and sustaining diabetes care program at the PHC level in Delta State is agreed to be the responsibility of all stakeholders. There is need to enhance capacity/knowledge among community members living with diabetes, and opportunity/practice among the HCPs, but most importantly attitude/motivation of all stakeholders.