Self-Management Practices among Children Presenting With Type 1 Diabetes Attending Selected Health Facilities in Nairobi City County, Kenya
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Date
2025-06
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Publisher
Kenyatta University
Abstract
Diabetes is a prevalent non-communicable disease (NCD) with a significant burden in low and middle-income Countries (LMICs). Diabetes is rising globally, with an estimated 589 million individuals having diabetes in 2024 and 853 million by 2050. In sub-Saharan Africa, 25 million adults have been diagnosed with diabetes, with a prevalence rate of 4.2%. Approximately 813,300 adults in Kenya currently suffer from diabetes with projections of 1.8 million increase by 2050. Estimates suggest that 9,500 children in Africa and 5,575 in Kenya have type 1 diabetes. Most children with T1D in the region die undiagnosed at clinical onset. Self-management is necessary for effective treatment and clinical outcomes, as well as reducing healthcare utilization and costs. This study aimed to evaluate self-management practices among children presenting with T1D using an analytical cross-sectional design. The researcher obtained qualitative and quantitative data through a researcher-administered questionnaire, focused group discussions, and interviews with key informants who were the primary caregivers and health service providers. The principal investigator entered the data into Excel for management and then conducted a cleaning and verification process to ensure its accuracy and reliability. This process included performing descriptive statistical analysis, which involved calculating frequencies, percentages, means, and standard deviations. The cleaned data was then transferred for analysis purposes; the researcher employed version 23 of the Statistical Package for Social Sciences (SPSS). The study investigated the socio-demographic and economic profiles of children with type 1 diabetes, their level of knowledge regarding self-management practices, and the self-management practices carried out by these respondents and explored the relationship between socio-demographic and economic factors, knowledge levels, and self-management practices among children with T1D. The study involved children with T1D aged between 8 and 18 years in Nairobi City County, Kenya, and attained a 94.9% response rate. Most of the respondents were girls (65.6%), with a median age of 14.67 years and a standard deviation of 3; most lived in low-income residences and had completed primary education, while most caregivers were self-employed. While 95.9% of the respondents recognized self management practices, further probing revealed that only 3.3% had adequate knowledge about coping strategies and 13.7% understood medication adherence. In practice,67.4% had medication adherence, and 53.4% monitored their blood glucose daily. However, a smaller proportion engaged in healthy problem-solving (29.9%) and physical activity (43.4%). Positive correlations were identified between self management practices and factors influencing them, including the age, education, and knowledge levels of children, along with the employment and marital status of their primary caregivers. The findings indicated a need for comprehensive, focused strategies to address knowledge gaps and overcome challenges that hinder children from effectively carrying out self-management practices. There is a need for targeted education, support systems, and individualized interventions among the children to improve the way they manage their diabetes.
Description
A Thesis Submitted in Partial Fulfilment of the Requirements for the Award of the Degree of Master of Public Health (Monitoring and Evaluation) in the School Of Health Sciences of Kenyatta University, June 2025.
Supervisor
1. Alloys S. S Orago
2. Albert G. Gachau