Factors influencing timely initiation and completion of gestational diabetes mellitus screening and diagnosis: a qualitative study from Tamil Nadu, India

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Factors influencing timely initiation and completion of gestational diabetes mellitus screening and diagnosis : a qualitative study from Tamil Nadu, India. / Nielsen, Karoline Kragelund; Rheinländer, Thilde; Kapur, Anil; Damm, Peter; Seshiah, Veerasamy; Bygbjerg, Ib C.

In: B M C Pregnancy and Childbirth, Vol. 17, 255, 01.08.2017, p. 1-13.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Nielsen, KK, Rheinländer, T, Kapur, A, Damm, P, Seshiah, V & Bygbjerg, IC 2017, 'Factors influencing timely initiation and completion of gestational diabetes mellitus screening and diagnosis: a qualitative study from Tamil Nadu, India', B M C Pregnancy and Childbirth, vol. 17, 255, pp. 1-13. https://doi.org/10.1186/s12884-017-1429-y

APA

Nielsen, K. K., Rheinländer, T., Kapur, A., Damm, P., Seshiah, V., & Bygbjerg, I. C. (2017). Factors influencing timely initiation and completion of gestational diabetes mellitus screening and diagnosis: a qualitative study from Tamil Nadu, India. B M C Pregnancy and Childbirth, 17, 1-13. [255]. https://doi.org/10.1186/s12884-017-1429-y

Vancouver

Nielsen KK, Rheinländer T, Kapur A, Damm P, Seshiah V, Bygbjerg IC. Factors influencing timely initiation and completion of gestational diabetes mellitus screening and diagnosis: a qualitative study from Tamil Nadu, India. B M C Pregnancy and Childbirth. 2017 Aug 1;17:1-13. 255. https://doi.org/10.1186/s12884-017-1429-y

Author

Nielsen, Karoline Kragelund ; Rheinländer, Thilde ; Kapur, Anil ; Damm, Peter ; Seshiah, Veerasamy ; Bygbjerg, Ib C. / Factors influencing timely initiation and completion of gestational diabetes mellitus screening and diagnosis : a qualitative study from Tamil Nadu, India. In: B M C Pregnancy and Childbirth. 2017 ; Vol. 17. pp. 1-13.

Bibtex

@article{421b50a432a4467187c693747a8d872c,
title = "Factors influencing timely initiation and completion of gestational diabetes mellitus screening and diagnosis: a qualitative study from Tamil Nadu, India",
abstract = "BACKGROUND: In 2007, universal screening for gestational diabetes mellitus (GDM) was introduced in Tamil Nadu, India. To identify factors hindering or facilitating timely initiation and completion of the GDM screening and diagnosis process, our study investigated how pregnant women in rural and urban Tamil Nadu access and navigate different GDM related health services.METHODS: The study was carried out in two settings: an urban private diabetes centre and a rural government primary health centre. Observations of the process of screening and diagnosis at the health centres as well as semi-structured interviews with 30 pregnant women and nine health care providers were conducted. Data was analysed using qualitative content analysis.RESULTS: There were significant differences in the process of GDM screening and diagnosis in the urban and rural settings. Several factors hindering or facilitating timely initiation and completion of the process were identified. Timely attendance required awareness, motivation and opportunity to attend. Women had to attend the health centre at the right time and sometimes at the right gestational age to initiate the test, wait to complete the test and obtain the test report in time to initiate further action. All these steps and requirements were influenced by factors within and outside the health system such as getting right information from health care providers, clinic timings, characteristics of the test, availability of transport, social network and support, and social norms and cultural practices.CONCLUSIONS: Minimising and aligning complex stepwise processes of prenatal care and GDM screening delivery and attention to the factors influencing it are important for further improving and expanding GDM screening and related services, not only in Tamil Nadu but in other similar low and middle income settings. This study stresses the importance of guidelines and diagnostic criteria which are simple and feasible on the ground.",
keywords = "Journal Article",
author = "Nielsen, {Karoline Kragelund} and Thilde Rheinl{\"a}nder and Anil Kapur and Peter Damm and Veerasamy Seshiah and Bygbjerg, {Ib C.}",
year = "2017",
month = "8",
day = "1",
doi = "10.1186/s12884-017-1429-y",
language = "English",
volume = "17",
pages = "1--13",
journal = "B M C Pregnancy and Childbirth",
issn = "1471-2393",
publisher = "BioMed Central Ltd.",

}

RIS

TY - JOUR

T1 - Factors influencing timely initiation and completion of gestational diabetes mellitus screening and diagnosis

T2 - a qualitative study from Tamil Nadu, India

AU - Nielsen, Karoline Kragelund

AU - Rheinländer, Thilde

AU - Kapur, Anil

AU - Damm, Peter

AU - Seshiah, Veerasamy

AU - Bygbjerg, Ib C.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - BACKGROUND: In 2007, universal screening for gestational diabetes mellitus (GDM) was introduced in Tamil Nadu, India. To identify factors hindering or facilitating timely initiation and completion of the GDM screening and diagnosis process, our study investigated how pregnant women in rural and urban Tamil Nadu access and navigate different GDM related health services.METHODS: The study was carried out in two settings: an urban private diabetes centre and a rural government primary health centre. Observations of the process of screening and diagnosis at the health centres as well as semi-structured interviews with 30 pregnant women and nine health care providers were conducted. Data was analysed using qualitative content analysis.RESULTS: There were significant differences in the process of GDM screening and diagnosis in the urban and rural settings. Several factors hindering or facilitating timely initiation and completion of the process were identified. Timely attendance required awareness, motivation and opportunity to attend. Women had to attend the health centre at the right time and sometimes at the right gestational age to initiate the test, wait to complete the test and obtain the test report in time to initiate further action. All these steps and requirements were influenced by factors within and outside the health system such as getting right information from health care providers, clinic timings, characteristics of the test, availability of transport, social network and support, and social norms and cultural practices.CONCLUSIONS: Minimising and aligning complex stepwise processes of prenatal care and GDM screening delivery and attention to the factors influencing it are important for further improving and expanding GDM screening and related services, not only in Tamil Nadu but in other similar low and middle income settings. This study stresses the importance of guidelines and diagnostic criteria which are simple and feasible on the ground.

AB - BACKGROUND: In 2007, universal screening for gestational diabetes mellitus (GDM) was introduced in Tamil Nadu, India. To identify factors hindering or facilitating timely initiation and completion of the GDM screening and diagnosis process, our study investigated how pregnant women in rural and urban Tamil Nadu access and navigate different GDM related health services.METHODS: The study was carried out in two settings: an urban private diabetes centre and a rural government primary health centre. Observations of the process of screening and diagnosis at the health centres as well as semi-structured interviews with 30 pregnant women and nine health care providers were conducted. Data was analysed using qualitative content analysis.RESULTS: There were significant differences in the process of GDM screening and diagnosis in the urban and rural settings. Several factors hindering or facilitating timely initiation and completion of the process were identified. Timely attendance required awareness, motivation and opportunity to attend. Women had to attend the health centre at the right time and sometimes at the right gestational age to initiate the test, wait to complete the test and obtain the test report in time to initiate further action. All these steps and requirements were influenced by factors within and outside the health system such as getting right information from health care providers, clinic timings, characteristics of the test, availability of transport, social network and support, and social norms and cultural practices.CONCLUSIONS: Minimising and aligning complex stepwise processes of prenatal care and GDM screening delivery and attention to the factors influencing it are important for further improving and expanding GDM screening and related services, not only in Tamil Nadu but in other similar low and middle income settings. This study stresses the importance of guidelines and diagnostic criteria which are simple and feasible on the ground.

KW - Journal Article

U2 - 10.1186/s12884-017-1429-y

DO - 10.1186/s12884-017-1429-y

M3 - Journal article

VL - 17

SP - 1

EP - 13

JO - B M C Pregnancy and Childbirth

JF - B M C Pregnancy and Childbirth

SN - 1471-2393

M1 - 255

ER -

ID: 183577471