Diabetes dietary self-care adherence in Ghana: a qualitative exploration of the roles of stakeholders

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OBJECTIVE: To explore how key stakeholders contribute to dietary self-care support for adults with type 2 diabetes receiving outpatient care in diabetes clinics in the Ashanti Region of Ghana. DESIGN: Descriptive phenomenological study. Purposive sampling technique was used to recruit the participants. A total of thirty-one interviews were conducted using a semi-structured interview guide. Reflexive thematic analytical framework was followed to analyse the data. SETTING: Diabetes clinics in the Ashanti region of Ghana: Komfo Anokye Teaching Hospital, Manhyia District Hospital, Ejisu Government Hospita and Juaben Government Hospital. PARTICIPANTS: Healthcare providers, family caregivers and officials of health directorates. RESULTS: Healthcare professionals contributed to dietary self-care by framing and interpreting dietary knowledge, offering psychological care and support and preparing family caregivers for their caregiving responsibilities. Family caregivers supported adherence by providing emotional reinforcement and behavioural motivation, assuming responsibility for managing the daily realities of dietary self-care and mobilising material and financial resources. Directors and officers at the health directorate contributed through supervision and quality control and through capacity building. CONCLUSION: The study underscores a need for continuous professional development programmes for healthcare providers, equipping them with updated knowledge on dietary counselling, psychological support and caregiver training. Additionally, the role of health directorates in supervising healthcare facilities and facilitating training programmes underscores the importance of strengthening institutional frameworks that ensure adherence to evidence-based dietary guidelines. Furthermore, the study highlights a need for healthcare facilities to strengthen the recognition and formalisation of the role of family caregivers in diabetes self-care practices.

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