Improving Type II Diabetes Care in West Africa: A Scoping Review of Barriers, Facilitators and the Way Forward

作者：Abdul-Basit Abdul-Samed, Yasmin Jahan, Veronika Reichenberger, Ellen Peprah, Mary Pomaa Agyekum, Henry Lawson, Dina Balabanova, Tolib Mirzoev, Irène Akua Agyepong · 发表于：medRxiv · 年份：2024 · DOI：10.1101/2024.08.30.24312843 · 被引用次数：7 · 研究领域：Diabetes Management and Education、Chronic Disease Management Strategies、Diabetes, Cardiovascular Risks, and Lipoproteins

Abstract Background The prevalence of diabetes is rising rapidly across West Africa, posing a significant public health challenge. Effective diabetes management through accessible and quality primary healthcare is crucial, yet multiple barriers persist. This review aimed to synthesise the available evidence on factors influencing access, utilisation, and quality of diabetes primary care in West Africa. Methods Our scoping review followed Arksey and O’Malley’s methodology and PRISMA-ScR guidelines. We comprehensively searched electronic databases and grey literature for studies covering 2000-2023 that reported factors related to diabetes primary care in West African countries. Data was extracted and analysed through a framework synthesis approach integrating the World Health Organisation Operational Framework for Primary Health Care, the Social Determinants of Health model, and the Innovative Care for Chronic Conditions model. Results Twelve studies were included from Nigeria (n=7), Ghana (n=4), and Senegal (n=1). Key barriers to access, utilisation, and quality were identified as health system deficiencies, including lack of infrastructure, workforce shortages, supply gaps, fragmented care coordination, absence of standardised guidelines, high costs of care, and limited governance for chronic disease management. Broader determinants of health, such as poverty, gender, cultural beliefs, reliance on traditional medicine, and health policy gaps, were found to influence access to...