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  3. ASSESSING THE QUALITY AND BARRIERS OF OUTPATIENT DIABETES CARE AT A SECONDARY HEALTH FACILITY IN THE BONO REGION
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Daniel Ankamah Mensah , Rev. Sr. Judith Beatrice Magbity

ASSESSING THE QUALITY AND BARRIERS OF OUTPATIENT DIABETES CARE AT A SECONDARY HEALTH FACILITY IN THE BONO REGION

The increasing prevalence of diabetes continues to place a heavy burden on the healthcare systems and the clients in Africa. Despite the increasing burden of Type 2 Diabetes Mellitus (T2DM) in Ghana, information about the quality of T2DM care in Ghana is scanty. This study assessed the quality and barriers of outpatient’s diabetes care at the Diabetic Clinic in the Berekum Municipality, Bono region of Ghana. A mixed-method study design involving a cross-sectional study and exploratory study was conducted from September to November 2020 using 191 diabetic clients aged 20 to 79 and 4 health professionals at the Diabetic Clinic. Participants were administered with a structured questionnaire, and patients’ data were retrieved from the clinic’s records. Data were collected on the readiness of the diabetic clinic, care processes, health outcomes and challenges faced by the diabetic clients and the care providers. The mean age of the respondents was 57.8 (SD + 10.5) years, with a mean disease duration of 7.40 (SD + 6.186) years and a median disease duration of 6 years (IQR = 7). The overall capacity of the diabetic clinic to provide diabetes care was 79.29%. Insufficiencies were found in items relating to trained staff, adequate guidelines, capacity building for staff, sanitary area, equipment, diagnostic capacity and availability of support systems. There were key challenges to diabetes care in addition to high medical costs. Regarding the process of care, all participants received blood glucose and blood pressure measurements. Annual screening for microvascular complications was very low. Glycated haemoglobin test (HbA1c), foot and eye examinations were also performed for only 5.2%, 0% and 15.2% of the respondents, respectively. For the outcome of care, 24.1%, 53.9% and 72.2% had controlled blood glucose levels, blood pressure and blood cholesterol, respectively. Only 17.6% of respondents achieved their glycaemic targets, 85.3% reported having at least one complication, and 62.3% reported having at least one comorbidity. The quality of diabetes care provided at the diabetic clinic was sub-optimal, especially the care process and health outcome indicators. The screening for complications was low in most of the clients, pointing out the need to improve screening practices. Providing standard treatment guidelines, regular training of health professionals, routine supervision and the adoption of cost-effective care strategies can improve the care processes leading to better health outcomes.