Health system and societal barriers for gestational diabetes mellitus (GDM) services - lessons from World Diabetes Foundation supported GDM projects

<p>Abstract</p> <p>Background</p> <p>Maternal mortality and morbidity remains high in many low- and middle-income countries (LMIC). Gestational Diabetes Mellitus (GDM) represents an underestimated and unrecognised impediment to optimal maternal health in LMIC; left untr...

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Main Authors: Nielsen Karoline Kragelund, de Courten Maximilian, Kapur Anil
Format: Article
Language:English
Published: BMC 2012-12-01
Series:BMC International Health and Human Rights
Subjects:
Online Access:http://www.biomedcentral.com/1472-698X/12/33
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author Nielsen Karoline Kragelund
de Courten Maximilian
Kapur Anil
author_facet Nielsen Karoline Kragelund
de Courten Maximilian
Kapur Anil
author_sort Nielsen Karoline Kragelund
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Maternal mortality and morbidity remains high in many low- and middle-income countries (LMIC). Gestational Diabetes Mellitus (GDM) represents an underestimated and unrecognised impediment to optimal maternal health in LMIC; left untreated – it also has severe consequences for the offspring. A better understanding of the barriers hindering detection and treatment of GDM is needed. Based on experiences from World Diabetes Foundation (WDF) supported GDM projects this paper seeks to investigate societal and health system barriers to such efforts.</p> <p>Methods</p> <p>Questionnaires were filled out by 10 WDF supported GDM project partners implementing projects in eight different LMIC. In addition, interviews were conducted with the project partners. The interviews were analysed using content analysis.</p> <p>Results</p> <p>Barriers to improving maternal health related to GDM nominated by project implementers included lack of trained health care providers - especially female doctors; high staff turnover; lack of standard protocols, consumables and equipment; financing of health services and treatment; lack of or poor referral systems, feedback mechanisms and follow-up systems; distance to health facility; perceptions of female body size and weight gain/loss in relation to pregnancy; practices related to pregnant women’s diet; societal negligence of women’s health; lack of decision-making power among women regarding their own health; stigmatisation; role of women in society and expectations that the pregnant woman move to her maternal home for delivery.</p> <p>Conclusions</p> <p>A number of barriers within the health system and society exist. Programmes need to consider and address these barriers in order to improve GDM care and thereby maternal health in LMIC.</p>
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spelling doaj.art-9ebb6096fc454dba8f12a7744a5ee1222022-12-21T20:17:24ZengBMCBMC International Health and Human Rights1472-698X2012-12-011213310.1186/1472-698X-12-33Health system and societal barriers for gestational diabetes mellitus (GDM) services - lessons from World Diabetes Foundation supported GDM projectsNielsen Karoline Kragelundde Courten MaximilianKapur Anil<p>Abstract</p> <p>Background</p> <p>Maternal mortality and morbidity remains high in many low- and middle-income countries (LMIC). Gestational Diabetes Mellitus (GDM) represents an underestimated and unrecognised impediment to optimal maternal health in LMIC; left untreated – it also has severe consequences for the offspring. A better understanding of the barriers hindering detection and treatment of GDM is needed. Based on experiences from World Diabetes Foundation (WDF) supported GDM projects this paper seeks to investigate societal and health system barriers to such efforts.</p> <p>Methods</p> <p>Questionnaires were filled out by 10 WDF supported GDM project partners implementing projects in eight different LMIC. In addition, interviews were conducted with the project partners. The interviews were analysed using content analysis.</p> <p>Results</p> <p>Barriers to improving maternal health related to GDM nominated by project implementers included lack of trained health care providers - especially female doctors; high staff turnover; lack of standard protocols, consumables and equipment; financing of health services and treatment; lack of or poor referral systems, feedback mechanisms and follow-up systems; distance to health facility; perceptions of female body size and weight gain/loss in relation to pregnancy; practices related to pregnant women’s diet; societal negligence of women’s health; lack of decision-making power among women regarding their own health; stigmatisation; role of women in society and expectations that the pregnant woman move to her maternal home for delivery.</p> <p>Conclusions</p> <p>A number of barriers within the health system and society exist. Programmes need to consider and address these barriers in order to improve GDM care and thereby maternal health in LMIC.</p>http://www.biomedcentral.com/1472-698X/12/33Gestational diabetes mellitusHealth systemSocietyBarriersLow- and middle-income countries
spellingShingle Nielsen Karoline Kragelund
de Courten Maximilian
Kapur Anil
Health system and societal barriers for gestational diabetes mellitus (GDM) services - lessons from World Diabetes Foundation supported GDM projects
BMC International Health and Human Rights
Gestational diabetes mellitus
Health system
Society
Barriers
Low- and middle-income countries
title Health system and societal barriers for gestational diabetes mellitus (GDM) services - lessons from World Diabetes Foundation supported GDM projects
title_full Health system and societal barriers for gestational diabetes mellitus (GDM) services - lessons from World Diabetes Foundation supported GDM projects
title_fullStr Health system and societal barriers for gestational diabetes mellitus (GDM) services - lessons from World Diabetes Foundation supported GDM projects
title_full_unstemmed Health system and societal barriers for gestational diabetes mellitus (GDM) services - lessons from World Diabetes Foundation supported GDM projects
title_short Health system and societal barriers for gestational diabetes mellitus (GDM) services - lessons from World Diabetes Foundation supported GDM projects
title_sort health system and societal barriers for gestational diabetes mellitus gdm services lessons from world diabetes foundation supported gdm projects
topic Gestational diabetes mellitus
Health system
Society
Barriers
Low- and middle-income countries
url http://www.biomedcentral.com/1472-698X/12/33
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