Assessment of quality of diabetes care and treatment in Mwanza region.

Abstract

Quality health care to patients with diabetes has been shown to have significant positive patient outcomes as well as reduce overall economic burden on the health care system. A cross sectional study was conducted to determine the quality of health care provided to patients in Mwanza region .The Type 2 Diabetes Clinical Practice Guidelines for Sub- Saharan Africa, 2006 was used as the recommended standards of care in the study. Fifteen (94%) health facilities with diabetic clinics in the region were assessed and a total of 411 patients were enrolled in the study. A structured questionnaire and observation methods were used to collect information on structural quality. Process and Outcome quality were assessed using structured questionnaires, physical measurement of patients as well as biochemical measurements. Results show that facilities had inadequate capacity in health personnel attending to diabetes patients in terms of both quality and quantity. Results also show that most of the health facilities lacked necessary capacity for screening majority of complications. However most had capacity for measuring blood pressure and blood glucose. Mean Body Mass Index (BMI), Glycosylated Haemoglobin Ic (HBA1c), Fasting Blood Glucose (FBG), Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) was 25.5kg/m2, 8.8%, 11.1 mmolll, 130 mmHg and 80 mmHg respectively. The prevalence of reported complications was high and the overall results show that there is poor glycaemic control among patients. The study shows that although some of the clinics had some basic facilities for providing diabetes care, the quality of care provided to patients with diabetes has been sub optimal resulting in to poor patient outcome of treatment hence major efforts are needed to improve quality of care provided and consequently patients' outcome of treatment.