Perceived barriers and facilitators to diet and physical activity among adults diagnosed with type 2 diabetes in Malawi

ABSTRACT

Diet and physical activity are crucial to Type 2 diabetes mellitus (T2DM) self-management. However, socio-environmental, and cultural factors can impede lifestyle behaviours, and hence T2DM management. This study aimed to identify barriers, facilitators and support for diet and physical activity among adults with T2DM in Malawi selected from a larger clinical assessment study, conducted in urban and semi-urban public hospitals. Four focus group discussions were conducted, and audio-recorded, transcribed verbatim, coded, then organised and analysed using thematic analysis. Emergent themes included: family, friends, and health worker ties that facilitated both diet and physical activity as socio-support systems. Diabetes peer groups occurred more often in urban than semi-urban areas. Dietary barriers to self-management of T2DM included: cost and access to food; lack of knowledge on what and how much to eat; challenges of separate preparation and purchase of food; dilemmas of what to eat during functions and travel; and conflicting dietary information from different sources. Comorbidities and fear of public ridicule were key perceived barriers to participants being physically active. Therefore, socio-environmental factors should be considered by nutritionists, dietitians, and health workers when developing and providing nutrition and physical activity education to adults with T2DM in Malawi.

KEY WORD:

• Barriers
• Diet
• Facilitators
• Physical activity
• Type 2 diabetes
• Malawi

Acknowledgements

We appreciate the adults diagnosed with T2DM in Malawi who participated in this study, and government officials at Kamuzu Central Hospital and Kasungu District Hospital for their support and granting permission to conduct the research.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This material is based upon work supported by the United States Agency for International Development, as part of the Feed the Future Initiative, under the CGIAR Fund, award number BFS-G-11-00002, and the predecessor fund the Food Security and Crisis Mitigation II grant, award number EEM-G-00-04-00013.