Perspectives of healthcare providers and patients with type 2 diabetes mellitus on improving glycaemic control in Kinshasa, Democratic Republic of the Congo: a qualitative study

Abstract

Abstract Background Despite advances in the therapeutic management of type 2 diabetes, glycaemic control remains suboptimal in sub-Saharan Africa, including in the Democratic Republic of the Congo (DRC). Defining interventions to improve glycaemic control requires a clear knowledge of local factors related to poor glycaemic control including the views and perspectives of key stakeholders such as healthcare providers and patients. Qualitative studies exploring these are lacking in the DRC. The aim of this study was to explore the perspectives of patients with type 2 diabetes and healthcare providers on ways to improve glycaemic control in the DRC. Methods This qualitative study utilized in-depth interviews conducted on 26 purposefully sampled participants − 10 patients with type 2 diabetes and 16 healthcare providers in Kinshasa, Democratic Republic of the Congo. The study used phenomenology approach, and inductive, constructionist, and thematic analysis. Themes were organized and integrated using the Innovative Care for Chronic Diseases Framework. Results Three themes were identified regarding improving glycaemic control: strengthening the healthcare system, supporting patients and population, and adopting supportive health policies. The improvement of glycaemic control involves actions from the patients and families, the healthcare organisations and the community, and policy environment. The patients should be empowered for self-management through a patient-provider relationship that is patient-centred. The care offered to patients with diabetes should be evidence-based and provided by multidisciplinary healthcare teams in well-equipped healthcare facilities. At the community level, efforts should focus on improving people’s knowledge of diabetes and provide more support to patients. At the policy level, primary prevention of diabetes and effective healthcare financing should be assured. Conclusion This study found that the improvement of glycaemic control for patients with type 2 diabetes in Kinshasa, DRC requires multidimensional strategies that include patient, family and community level interventions; structural and processes of care interventions in the health system; and health policy level interventions. To be efficient, these interventions need to be integrated into existing platforms of healthcare services delivery, particularly the chronic diseases management framework.