Barriers and strategies in care delivery for type 1 diabetes in Sub-Saharan Africa: a scoping review
摘要
Type 1 diabetes is one of the most common chronic diseases in children. More than 1.2 million young people under the age of 20 are affected, the majority of whom live in low-income countries. The care delivery of type 1 diabetes in sub-Saharan Africa is an important part of protecting children’s health, preventing complications, and supporting families in vulnerable populations. This scoping review aims to describe and categorize the most important barriers to type 1 diabetes care delivery in Sub-Saharan Africa and provides an overview of the types of strategies that are used to overcome these barriers.
MethodsScoping review methodology was used. Five online databases and a general web search for grey literature were searched. Eligibility criteria were applied by two reviewers, and data were extracted and analysed by one reviewer. All studies published or unpublished from 1990 until the end of 2020 were considered. The content was analyzed using a qualitative synthesis approach.
ResultsResearch, including publications from 1990 to 2019, identified 504 studies, narrowed down to 38 after review. All studies were based in sixteen Sub-Saharan African countries, limiting the generalizability of our results. Barriers to the care delivery of type 1 diabetes in Sub-Saharan Africa are related to contextual factors at several levels: health system, policy, structure and performance, patient factors, and socio-cultural factors. The core elements of successful strategies for care delivery of type 1 diabetes are education, staff training, and social support.
ConclusionsAvailable evidence indicates that structured care delivery can improve the health of people living with type 1 diabetes in Sub-Saharan Africa. Obstacles in the case and population care delivery of type 1 diabetes and the health of people living with type 1 diabetes need to be analyzed before strategies adapted to the context and specific target groups can be developed.