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

Abstract

Background/Objectives: Non-communicable diseases including Diabetes Mellitus are increasingly becoming 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 associated with worse health outcomes, leading to the increasing burden of diabetes in many developing countries including Rwanda. This study aimed to assess healthcare service utilization and associated factors among patients with Diabetes Mellitus attending Kirehe District hospital (KDH)’s 17 catchment health centers in Rwanda. Design/Methods: The study employed retrospective health records review and key informant interview. The researchers conducted a review of patients’ health records and key informants interview. The sample size for the study was 272 patients’ health records drawn from the target population of 781 records, covering a period of one year. For the key informants interview, one health worker each was selected from the 17 health centers. Quantitative data were analyzed using descriptive statistics and Chi-square computation using IBM.SPSS.v21, while qualitative data was analyzed thematically. Results: The study found that more than half (54%) of the participants had missed more than three DM clinic appointments with 84.9% missing at least an appointment. Only 15.1% adhered to all appointments. Demographic factors such as education level, social status and marital status, were significantly associated with health service utilization at p <0.005. Some participant-related characteristics such as current medication and time of diagnosis were also significantly associated with health service utilization at p <0. 005. Conclusion: The overall level of healthcare services utilization was low and there are some modifiable participant-related and health service-related factors influencing the utilization of healthcare services among DM patients in Rwanda. The study recommends that KDH and its partners put in place strategies to ensure an improvement of clinic appointment adherence by patients and improving system-related factors such as training and retention of staff, laboratory strengthening and medication availability as well as accessibility.