Obstetrics and gynecology international · 2026
Barriers to Early Detection and Management of Gestational Diabetes Mellitus in Northwest Ethiopia: A Qualitative Study From the Healthcare Providers' Perspectives.
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Mihiret Getachew Tilaye, Wondmu Kumlachew Solomon, Baye Fekadu, Minale Mulunesh, Yechale Mastewal, Melese Misganaw Fikirie, Melesse Yilkal Dagnaw, Haimanot Aysheshim Belaineh, Adebabay Aderajew Agmass, Amha Haile
Аннотация
BACKGROUND: Gestational diabetes mellitus (GDM) is a major public health challenge associated with adverse maternal and neonatal outcomes. In low-income countries such as Ethiopia, screening rates remain critically low, resulting in preventable complications and long-term burdens on the health system.
AIMS: This qualitative study examines healthcare providers' perspectives on barriers to the early diagnosis and management of GDM in northwest Ethiopia.
METHODS: A descriptive qualitative study was conducted among eight healthcare providers (midwives, an obstetrician, and general practitioners) delivering maternal health services at public hospitals in the Eastern Gojjam zone. Participants were purposively selected, and data were collected through in-depth interviews. Interviews were audio-recorded, transcribed, translated, and analyzed using inductive thematic analysis in NVivo 12.2. The socioecological model guided the synthesis of barriers across multiple levels.
RESULTS: Providers reported a cascade of barriers spanning individual, community, and health system levels. Health system level barriers were most prominent, including shortages of trained staff, lack of essential supplies (glucometers, test strips), overcrowding leading to prolonged waiting times, and the absence of preconception care services. At the individual level, late antenatal booking and limited patient awareness hindered timely diagnosis. Community-level barriers included cultural beliefs that fostered denial of diagnosis and reliance on traditional remedies, further impeding care engagement.
CONCLUSION AND RECOMMENDATIONS: Early detection and management of GDM in Northwest Ethiopia remain constrained by a complex interplay of individual knowledge gaps, cultural norms, and systemic health service weaknesses. Addressing these challenges requires a comprehensive health systems approach that concurrently strengthens infrastructure, expands human resource capacity, and fosters community engagement. Such an integrated strategy is essential to translate national policy into equitable and effective practice, ultimately improving maternal and neonatal outcomes.
AIMS: This qualitative study examines healthcare providers' perspectives on barriers to the early diagnosis and management of GDM in northwest Ethiopia.
METHODS: A descriptive qualitative study was conducted among eight healthcare providers (midwives, an obstetrician, and general practitioners) delivering maternal health services at public hospitals in the Eastern Gojjam zone. Participants were purposively selected, and data were collected through in-depth interviews. Interviews were audio-recorded, transcribed, translated, and analyzed using inductive thematic analysis in NVivo 12.2. The socioecological model guided the synthesis of barriers across multiple levels.
RESULTS: Providers reported a cascade of barriers spanning individual, community, and health system levels. Health system level barriers were most prominent, including shortages of trained staff, lack of essential supplies (glucometers, test strips), overcrowding leading to prolonged waiting times, and the absence of preconception care services. At the individual level, late antenatal booking and limited patient awareness hindered timely diagnosis. Community-level barriers included cultural beliefs that fostered denial of diagnosis and reliance on traditional remedies, further impeding care engagement.
CONCLUSION AND RECOMMENDATIONS: Early detection and management of GDM in Northwest Ethiopia remain constrained by a complex interplay of individual knowledge gaps, cultural norms, and systemic health service weaknesses. Addressing these challenges requires a comprehensive health systems approach that concurrently strengthens infrastructure, expands human resource capacity, and fosters community engagement. Such an integrated strategy is essential to translate national policy into equitable and effective practice, ultimately improving maternal and neonatal outcomes.