Women’s perspectives on gestational diabetes mellitus screening services during antenatal care in Tanzania

Abstract

BACKGROUND: Gestational diabetes mellitus (GDM) is the most common medical condition occurring during pregnancy. Screening for GDM during antenatal care (ANC) provides an opportunity to prevent its progress and complications. Women's experiences should help shape how GDM screening guidelines are implemented, which will further influence uptake and adherence to screening services. We aimed to explore women's experiences of receiving ANC at two hospitals in Tanzania where we introduced GDM screening services. METHODS: We employed an exploratory case study design in two district hospitals of Tanzania. We purposively recruited 22 women in 2024 who received ANC, which included GDM screening services. We conducted in-depth interviews using semi-structured interview guides, tape-recorded the interviews, transcribed verbatim, and analyzed the data using qualitative content analysis. Texts were condensed to meaningful units, abstracted to codes which were linked to the social-ecological model, developed sub-categories and categories. RESULTS: Participants described the suboptimal quality of health education and care provided during and after the GDM screening test. They expressed how the experience of receiving GDM screening services influenced their personal and community adaptations to a healthy lifestyle. Women suggested having GDM education in routine ANC health education sessions and to improve the timing and format of delivery of health education provided during ANC. Women expressed the need to simplify the logistics in doing the blood glucose tests, reduce user fees, and improve quality of care provided following the GDM screening test. CONCLUSIONS: GDM screening services should be offered as part of routine ANC services. Receiving GDM care within routine ANC improved women's perception of quality health care provided. Counselling and health education on GDM need to be strengthened to improve the quality of GDM care provided. Hospital health management teams should systematically engage the community and improve hospital logistics in offering quality GDM services during ANC.