Healthcare services utilization among patients with Diabetes Mellitus at Kirehe District, Rwanda

Abstract

Background/Objectives: Non-communicable diseases including Diabetes Mellitus are increasinglybecoming a major public health concern globally and particularly in low- and middle-income countries.Although healthcare services utilization is not a major concern in developed countries, it is associatedwith worse health outcomes, leading to the increasing burden of diabetes in many developing countriesincluding Rwanda. This study aimed to assess healthcare service utilization and associated factorsamong patients with Diabetes Mellitus attending Kirehe District hospital (KDH)’s 17 catchment healthcenters in Rwanda. Design/Methods: The study employed retrospective health records review and keyinformant interview. The researchers conducted a review of patients’ health records and key informantsinterview. The sample size for the study was 272 patients’ health records drawn from the targetpopulation of 781 records, covering a period of one year. For the key informants interview, one healthworker each was selected from the 17 health centers. Quantitative data were analyzed using descriptivestatistics and Chi-square computation using IBM.SPSS.v21, while qualitative data was analyzedthematically. Results: The study found that more than half (54%) of the participants had missed morethan three DM clinic appointments with 84.9% missing at least an appointment. Only 15.1% adhered toall appointments. Demographic factors such as education level, social status and marital status, weresignificantly associated with health service utilization at p <0.005. Some participant-relatedcharacteristics such as current medication and time of diagnosis were also significantly associated withhealth service utilization at p <0. 005. Conclusion: The overall level of healthcare services utilizationwas low and there are some modifiable participant-related and health service-related factors influencingthe utilization of healthcare services among DM patients in Rwanda. The study recommends that KDHand its partners put in place strategies to ensure an improvement of clinic appointment adherence bypatients and improving system-related factors such as training and retention of staff, laboratorystrengthening and medication availability as well as accessibility.Keywords: Diabetes Mellitus; Non-Communicable Diseases; Rwandan Diabetes Association; ServiceUtilization; Kirehe District