Abstract:
Non- Communicable Diseases (NCDs) emerges as a global burden, despite the efforts
being put in place by World Health Organization (WHO) and other health related
organizations. There is evidence that people with diabetes type 2 usually have more
than one co-existing chronic conditions often including, hypertension being the
leading condition yet healthcare systems are inadequately prepared to manage
chronic comorbid conditions such as diabetes and hypertension.
This study explored the antecedent or causal conditions relevant to the management
of chronic comorbid diabetes and hypertension in Nandi County rural settings.
Qualitative focused ethnography was used to collect data within the community and
grounded theory method used for data analysis using the paradigm model.
Purposeful sampling was used to select informants based on 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 and transcribed verbatim and
a series of coding was conducted leading to emergence of categories and core
phenomenon of study.
Results showed that management of chronic comorbid diabetes and hypertension in
primary health care commenced as a result of contextually relevant actions and
interactions taken to supervise the situation. These include: low literacy level on
comorbid diabetes and hypertension; preventable high hospital admission; delays in seeking medical help, high premature mortality cases, lack of default tracing system
and poor control levels in comorbid diabetes and hypertension. It was observed that
patients with comorbid diabetes and hypertension require comprehensive, long term
and timely interventions to improve health outcome and quality of life.