Introduction: Healthcare-seeking behaviour among persons with diabetes has been investigated to a limited extent, and not from professionals' perspective. The aim of the study was to describe healthcare professionals' knowledge, attitudes and practice concerning healthcare-seeking behaviour and the use of complementary and alternative medicine among persons with diabetes. Methods: A cross-sectional, self-administered questionnaire was conducted in western Uganda. Nurses, midwives or nurse assistants 72.2%, physicians 12% and clinical officers 10% volunteered to participate in the study with a total 108 (93% response rate) response rate. Descriptive statistics were used to analyse data with frequencies, percentages and summarized in tables. Results: Most of the healthcare providers perceived more uneducated people to be at risk of developing complications related to diabetes (66.7%) and that most of the patients with diabetes were not knowledgeable about signs and symptoms of diabetes before being diagnosed (75.9%). The main reasons inducing persons with diabetes to seek care outside the health care sector were reported to be seeking a cure for the condition, influence from the popular sector, the accessibility of the place and signs of complications of diabetes related to poor glycaemic control. Healthcare providers had relatively positive attitudes towards using complementary and alternative medicine. Conclusion: Insufficient knowledge about diabetes, compromised healthcare-seeking practices including drug procurement for diabetes seem to be barriers to diabetes management. Patients were thus reported to be burdened with co-morbidities of complications of diabetes related to poor glycaemic control.

Healthcare-seeking behaviour is important as it determines acceptance ofhealthcare and outcomes of chronic conditions, but it has been investigated to alimited extent, and not in developing countries. The overall aim was to explorehow persons with type 2 diabetes seek care to manage diabetes using differenthealthcare providers including the use of complementary alternative medicine andtraditional healers in Uganda. The study design was a combination of quantitativeand qualitative studies to explore and describe healthcare-seeking behaviour. Thethesis included 41 persons with type 2 diabetes, 16 traditional healers, and 108healthcare professionals. Individual semi-structured interviews, focus groupinterviews and self-administered questionnaires were used to collect data. Datawere analysed using qualitative content analysis, qualitative data analysis of focusgroup interviews and descriptive statistics of quantitative data.The preference health service provider for people with diabetes was identified asthe professional health sector. Healthcare was mainly sought, or perceived to besought, among doctors and nurses in the public hospitals. Perceived failure inhealthcare to manage diabetes or its complications led many, particularly women,to seek alternative treatment from complementary alternative medicinepractitioners. Reasons why persons with diabetes switched between differenthealthcare providers were symptoms of diabetes or complications related to poorglycemic control. Patients who sought alternative medicine reported to have beentired of taking western medicine as their condition did not improve or they hopedfor cure. Traditional therapies of patients with diabetes were mainly described asherbal medicine, nutritional products of local fruits and vegetables. Healthcareorganization, treatments costs, patients’ health beliefs, and general conditionseemed to have influenced healthcare-seeking practices.In conclusion, the pattern of care seeking was inconsistent, with a switch betweendifferent healthcare providers under the influence of the popular and folk sectors.Healthcare providers need to develop a well-designed package of diabetes andself-care management education designed to raise awareness about diabetes care atall levels. Nurses and other health professionals need to carry out a comprehensivehealth assessment to identify individuals’ educational needs in order to provideappropriate educational and clinical support, in well-organized diabetes care, tomaintain good health.

Background Healthcare-seeking behaviour has been investigated to a limited extent in persons with diabetes, and the way traditional healers manage diabetes still needs exploration. Aim To explore healthcare-seeking behaviour and management of type 2 diabetes from the perspective of traditional healers in the folk sector to understand how traditional medicine is integrated into the professional health sector. Design A qualitative descriptive study. Method A purposeful sample of 16 traditional healers known in the area. Data were collected by individual semi-structured interviews. Findings Healthcare was sought from the professional health sector, mainly from the public hospitals, before the patients switched to the traditional healers. Reasons for seeking help from traditional healers were mainly chronic conditions such as diabetes, high blood pressure and the perceived failure of western medicine to manage diabetes. The cost at the healers’ facilities also influenced healthcare seeking because it was perceived to be affordable as it was negotiable and accessible because it was always available. Traditional medicine therapies of patients with diabetes were herbal medicine, nutritional products and counselling, but many patients whose conditions were difficult to manage were told to return to the public hospitals in the professional health sector. Conclusion Healthcare seeking was inconsistent in character, with a switch between different healthcare providers. Living conditions including treatment costs, healthcare organization, patients’ health beliefs and general condition seemed to influence healthcare seeking practice. © 2016 The Authors

Introduction: Health-care seeking behaviour is important as it determines acceptance of health care and outcomes of chronic conditions but it has been investigated to a limited extent among persons with diabetes in developing countries. The aim of the study was to explore health-care seeking behaviour among persons with type 2 diabetes to understand reasons for using therapies offered by traditional healers.

Methods: Descriptive study using focus-group interviews. Three purposive focus-groups were conducted in 2011 of 10 women and 7 men aged 39–72 years in Uganda. Data were collected through semi-structured interviews and qualitatively analysed according to a method described for focus-groups.

Results: Reasons for seeking help from traditional healers were symptoms related to diabetes such as polydipsia, fatigue and decreased sensitivity in lower limbs. Failure of effect from western medicine was also reported. Treatment was described to be unknown extracts, of locally made products taken as herbs or food, and participants had sought help from different health facilities with the help of relatives and friends.

Conclusion: The pattern of seeking care was inconsistent, with a switch between different health care providers under the influence of the popular and folk sectors. Despite beliefs in using different healthcare providers seeking complementary and alternative medicine, participants still experienced many physical health problems related to diabetes complications. Health professionals need to be aware of the risk of switches between different health care providers, and develop strategies to initiate health promotion interventions to include in the care actors of significance to the patient from the popular, folk and professional sectors, to maintain continuity of effective diabetes care. © Katarina Hjelm et al.