Strengthening of Community Actions for People Living With Diabetes Mellitus in the Eastern Cape, South Africa: Utilizing Public Health Facilitators and Redressing Barriers

Abstract

Abstract Background Diabetes Mellitus is the second leading cause of death in South Africa and almost 90 000 people died from diabetes-related causes in the year 2019. The purpose of this study was to investigate facilitators that can be harnessed to strengthen community actions and barriers that should be redressed in structured public health and health promotion programs for people living with diabetes mellitus at a primary health care level. Methods Using face to face qualitative approach, an exploratory design was conducted. The Ottawa Charter was adopted as a model to guide health promotion strengthening actions for people living with diabetes mellitus. This study was conducted at Ngangelizwe Community Health Centre. Ngangelizwe is one of the townships located about 2 km east of Mthatha Town in the Eastern Cape Province of South Africa. Conveniently, 20 participants living with diabetes mellitus were selected to participate voluntarily in the study. Thematic analysis method with the assistance of Atlas ti version 9.0 software was used to analyse the data and presented under two broad themes. Results Five overarching themes were yielded and categorized as facilitators and barriers. Facilitators included enhancing the role of community healthcare workers, strengthening of health education activities. Barriers encompassed lack of support groups, lack of food security, and unavailability of community health promotion programs. Conclusion The study concluded with recommendation of designing health promotion program for primary health care prevention of diabetes mellitus at a community level. Engagement of collaborative intervention of relevant key stakeholders working together as a primary health care team, health promotion practitioners and community health care workers is recommended. The public health care team should be motivated to reach out into households and communities to empower people to have control over diabetes and improve their health.