The role of personal social networks in supporting patients with chronic diseases to access outpatient clinics in Mbeya, Tanzania: A mixed methods study

Abstract

The increasing prevalence of non-communicable diseases (NCDs) in Tanzania and the inequitable provision of NCD care drives patients to seek support from their social networks. We studied a sample of patients with NCDs attending outpatient clinics to understand how informal social support helps patients with NCDs in coping with their illness, and whether it is associated with patients’ engagement in care. We used mixed methods to analyse data from a client exit survey implemented in outpatient clinics in Mbeya, Tanzania in 2022. The quantitative analyses of data on 108 patients was complemented by qualitative analysis of in-depth interviews conducted on a sub-sample of 30 participants. Most patients faced difficulties completing work and household activities, creating a need for financial support. Expectations of reciprocal intergenerational support led patients’ children to be the dominant providers of financial support. Participants’ social ties frequently provided financial support, while emotional and informational support were provided to a lesser extent. Informal social support fills gaps in social health protection schemes and promotes engagement in care by providing patients with the means to finance uninsured costs of care. Expanding old age social security or other resource pooling mechanisms could reduce the susceptibility of patients and their support networks to catastrophic health expenditure, even for those with health insurance.