Social support for self-care: patient strategies for managing diabetes and hypertension in rural Uganda

Abstract Background The growing burden of non-communicable diseases (NCDs) threatens low-income countries. Self-care practices are crucial for successful management of NCDs to prevent complications. We sought to understand self-care efforts and their facilitators among patients with diabetes and hypertension in rural Uganda. Methods Between April and June 2019, we conducted a cross-sectional qualitative study among adult patients from outpatient NCD clinics at three health facilities in Uganda. We conducted 19 in-depth interviews exploring treatment practices and response to symptoms. We used content analysis to identify emergent themes. Results Three themes emerged in patients’ descriptions of their self-care practices. First, patients preferred conventional medicines as their first line of resort, but often used traditional medicines. In particular, patients used traditional medicines to mitigate the negative impacts of inconsistent access to conventional medicines and to supplement those medicines. Second, patients adopted a wide range of vernacular practices to supplement treatments and unavailable diagnostic tests, including tasting their urine to gauge blood-sugar level. Finally, patients sought social support for self-care activities, relying on networks of family members and peers for instrumental and emotional support. Patients saw their children as the most reliable source of support, especially money for medicines, transport and home necessities. Interpretation Patients valued conventional medicines but also engaged in varied self-care practices. They depended upon networks of social support from family and peers to maintain self-care. Interventions to improve self-care may be more effective if they improve access to medicines and engage or enhance patients’ social support networks.