Perspectives of healthcare workers on factors influencing diabetes management and diabetic foot problems in Zimbabwe

Background: Poor management of diabetes mellitus gives rise to complications such as diabetic foot (DF), which pose a host of medical and socioeconomic problems, especially in low-income countries where resources, capacity and awareness are limited. Aim: This study purposed to identify local factors influencing poor management of diabetes and, therefore, increasing risk of DF in Zimbabwe. Method: This study utilised a descriptive qualitative design with a purposive sample of 30 nurses from 14 polyclinics and 2 major referral hospitals in Harare, Zimbabwe. Four focus-group discussions were conducted following a semi-structured interview guide with sections addressing commonly encountered socio-economic, cultural and behavioural factors, which potentially increase the risk of DF complications among diagnosed and undiagnosed diabetic individuals. Thematic analysis was used to analyse the data. Results: Four major themes were identified including poor socioeconomic status, poor self-care, religious and cultural factors, and health-system-related factors. Lack of awareness results in poor health-seeking behaviour, and use of unconventional treatment methods, which may increase DF risk among people living with diabetes, both diagnosed and undiagnosed. Conclusion: Appropriately tailored education and awareness interventions taking into account local socio-economic and cultural factors are key to the prevention of DF and promotion of self-management activities.