Conceptualization of Management of Comorbid Diabetes and Hypertension Conditions in Kenya: A Focused Ethnographic Study

Document Abstract / Summary Overview

Background: Chronic Comorbid conditions are emerging to be a global concern; while management interventions remain being medical oriented and fragmented, with diminutive regard to the cultural aspects of people especially at the primary health care levels. Aim and settings: To understand how management of comorbid diabetes and hypertension is conceptualized in primary health care settings in Nandi County in the Kenyan from the patients and health care providers’ perspectives. Methods: Qualitative focused ethnography was used an approach of data collection within the community and grounded theory method was used for data analysis using the paradigm model. Purposeful sampling was used to select informants based experience and expertise related to management of comorbid diabetes and hypertension. Data was collected through triangulation of participant observation, interviews, focus group discussion and document analysis. Interviews were tape recorded, later transcribed verbatim, a series of coding was conducted leading to emergence of categories and core phenomenon of study. Results: The core phenomenon of management of chronic comorbid conditions was conceptualized in different variations; these included: being collaborative in nature involving multidisciplinary, multisectoral and community collaborations and patient being involved as a team member. Comorbid condition management requires coordination of care and timely service provision across care setting. Management of comorbid diabetes and hypertension requires culturally sensitive care. Self-management of chronic comorbid conditions is patient centred rather than problem focused with support family or minimally from health providers. Conclusion: Comprehensive management of chronic comorbid conditions has direct influence on the individual patients, community, health organization and health systems. This leads to improved health service provision and quality of life for people with comorbid conditions