Social outcomes of healthcare-seeking behavior among persons living with diabetes in Rongo sub- county, Migori county, Kenya

Abstract

Diabetes is a fast-growing health and socio-economic burden which manifests in social outcomes and is highly prevalent in Kenya due to the inadequacies of mitigation measures. It is manageable through appropriate healthcare-seeking behavior (HSB) comprising biomedical, alternative, and combined interventions. Migori County with one of the highest diabetes prevalence at 2.7%, surpassing the national average of 2.2% is more susceptible to adverse diabetes-related complications, specifically from malaria and HIV/AIDS. Rongo Sub-County registered the highest increment in diabetes clinic attendance in 2019 at 27.07% compared to other sub-counties in Migori County. This study sought to establish the social outcomes of HSB among persons living with diabetes. Specifically, it sought to determine the social outcomes of biomedical HSB, determine the social outcomes of alternative HSB, and determine the social outcomes of combining biomedical and alternative HSB. Social outcomes were explored in terms of ability to relate well with people, acquire life skills, and acquire nutritional knowledge. Literature review was done based on objectives and guided by the Health Belief Model. A convergent mixed-method approach involving a descriptive-exploratory design was adopted. Taro Yamane’s formula was used to select 257 respondents from a target population of 718 persons diagnosed with diabetes in Rongo Sub-County in 2019. Respondents were sampled using proportionate and simple random sampling. Six healthcare workers from purposively selected health facilities were interviewed. Ethical considerations were upheld. Data collection tools, comprising a questionnaire and interview schedule, were tested, resulting in validity and reliability indices of.826 and.865, respectively. Results were analyzed using the mean, standard deviation, and Spearman's rho correlation. Data was presented in frequency tables and bar graphs. Through computation of average means and standard deviation within a margin of -.2< SD <.2, the study found that biomedical HSB (average mean= 4.54), alternative HSB (average mean= 3.78), and combining biomedical and alternative HSB (average mean= 4.10), enabled respondents to acquire life skills, acquire nutritional knowledge and relate well with people. Using Spearman rho correlation, the study found a statistically significant and positive moderate relationship between social outcomes and biomedical HSB (.590, p=.000), a statistically significant and positive moderate relationship between social outcomes and alternative HSB (.562, p=.000), and a statistically significant and very strong positive relationship between social outcomes and combining biomedical and alternative HSB (rs= .879, p=.000). Qualitative data was thematically analysed and revealed that perceptions, experiences, and beliefs influenced HSB and impacts social outcomes. The study concludes that there was a significant positive relationship between social outcomes and HSB among persons living with diabetes in Rongo Sub-County. The study recommends that County Governments and MOH should step-up implementation of basic module for CHV curriculum on module 13 framework on NCDs package to upscale follow up and achieving of social outcomes; enhance investments in research on efficacy and compatibility of alternative medications thus enhancing achieving; and enhance policy implementation on patient-healthcare worker relationships to achieve social outcomes among persons living with diabetes.