Healthcare Providers’ Perception of Healthcare System Factors Associated with Poor Glycemic Control among Type 2 Diabetes Patients in Fiji

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Abstract
The Review of Diabetic Studies,2019,15,1,49-57.
Published:February 2019
Type:Original Article
Authors:
Author(s) affiliations:

Pablo Romakin1 and Masoud Mohammadnezhad2

1Ministry of Health and Medical Services, Suva, FIJI.

2School of Public Health and Primary Care, Fiji National University, Suva, FIJI.

Abstract:

Objective: This study aims to explore the perceptions and experiences of healthcare providers regarding the role of healthcare system factors on glycemic control among type 2 diabetes (T2D) patients in Fiji in 2018. Methods: Nineteen healthcare providers (physicians and nurses) from three randomly selected urban healthcare centers in Suva, Fiji, were selected through purposive variation sampling to participate in three focus group discussions (FGDs). The participants in this study were healthcare providers working in diabetes clinics, and medical officers and nurse team leaders from the selected healthcare centers. The data were analyzed by means of thematic analysis using Attride-Stirling’s thematic network analysis framework. Results: The majority of the participants (52.6%) were nurses, most of them female (84.2%), with a mean age of 39 years (SD ±9.2). A large part of the participants had been working in the diabetes clinics for more than 5 years (52.6%) and had more than 10 years’ experience (52.6%) in their current employment. Five main healthcare system factors that may affect glycemic control were identified during thematic analysis: 1. Healthcare workforce (shortage of staff, high workload). 2. Medicine, consumables, and equipment (regular stock-outs of basic diabetes medicines and consumables, poorly equipped diabetes clinics). 3. Service delivery (lack of effective diabetes service delivery, continuum of care). 4. Healthcare information system (inadequate, not fully functional, unreliable). 5. Infrastructure (lack of supportive diabetes clinic infrastructure and processes). Conclusion: Healthcare system factors influence glycemic control among T2D patients. Understanding these factors is important in order for healthcare providers to deliver an effective and efficient service for diabetes patients in Fiji.