Developing an evidence-based management model to mitigate the risk factors associated with gestational diabetes mellitus in the Mopani District of Limpopo Province, South Africa

Thesis (Ph.D. (Public Health)) -- University of Limpopo, 2024

Background: A model of care for non-communicable diseases (NCDs) has been developed to combat the growing burden of diseases in low-and-middle income countries due to sedentary lifestyles and westernised diets. Resources in these countries are often constrained and it is imperative that the health and well-being of people of all ages are ensured in order to minimise adverse health outcomes, mortality and morbidity. Purpose: This study was conducted with the aim to develop an evidence-based management model to mitigate risk factors and improve maternal and infant health outcomes associated with gestational diabetes mellitus in the Mopani district of the Limpopo province in South Africa. Methodology: A mixed-method exploratory sequential research design was used to best address the research question. Multistage sampling was used to select the health facilities under study. During qualitative phase one, a total of 12 key informants were purposively sampled to participate, and semi-structured interviews were conducted. During quantitative phase two. A total of 386 pregnant women attending antenatal clinic visits were randomly selected to participate in the study. A questionnaire was used to collect data, while a data entry form was used to capture information from maternity casebooks. Pregnant women who were diagnosed with gestational diabetes were purposively sampled to participate in a semi-structured interview. Qualitative data was analysed using thematic analysis while quantitative data was analysed using SPSS. Furthermore, the results from both phases were integrated and interpreted. Findings: The study has found few cases of gestational diabetes mellitus (GDM). Most pregnant women attending antenatal visits were unaware of GDM, its risk factors, complications, adverse health outcomes and treatment. A minority of pregnant women diagnosed with gestational diabetes were referred to a dietician and health education on gestational diabetes was only offered to pregnant women diagnosed with this health condition. Pregnant women who are 35 years of age and older are at risk of developing GDM. Intervention strategies to reduce modifiable risk factors were developed and validated using Delphi method. In addition, the strategies proposed informed the model, which was validated by calculating the content validation index. Conclusion: Awareness about gestational diabetes should be raised in communities and during antenatal clinics. This might have a positive impact on the prevalence of non communicable diseases and assist in achieving SGD no 3 by the year 2030