Assessment of the knowledge of community health workers about type 1 diabetes mellitus: a cross-sectional study from rural Karnataka
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20252124Keywords:
Awareness, Accredited social health activists , Community health workers, Diabetes management, Knowledge assessment, Type 1 diabetes mellitusAbstract
Background: Type 1 diabetes mellitus (T1DM) is a chronic autoimmune condition primarily affecting children and young adults, requiring lifelong insulin management. Optimum management and early diagnosis are essential to prevent further health complications. In rural India, accredited social health activists (ASHAs), as frontline community health workers, play a key role in health education and early intervention. However, their knowledge regarding T1DM is less explored. Thus, this study aimed to assess the baseline knowledge of ASHA workers and community health workers (CHWs) about T1DM in rural and urban primary health centres of Bengaluru rural district, Karnataka, India.
Methods: A cross-sectional study was conducted in Karnataka, over a time-period of 3 months in 2024, among 156 ASHA workers selected through systematic random sampling from primary health centres (PHCs) attached to the medical institution. A pretested, semi-structured questionnaire was used to assess knowledge on T1DM and its definition, symptoms, risk factors, complications, and management. Knowledge levels were categorized as good, adequate, or poor based on the number of correct responses.
Results: According to the survey, only 14.1% of the participants had heard of type 1 diabetes, and only 11.5% had received training on the condition. 64.7% of participants were unable to distinguish between type 1 and type 2 diabetes, and the majority (64.1%) were not aware of its usual pediatric onset. There were many misconceptions, as 55.1% of individuals believed that consuming excessive sugar was the cause of T1DM. Just 25% of respondents correctly identified each significant symptom. 90.4% of the study participants fell under the poor knowledge category as they answered only 1-5 questions correctly.
Conclusions: The study revealed a significant knowledge gap among CHWs and ASHA workers regarding T1DM. This underscores the urgent requirement to include focused T1DM education in ASHA educational modules. Improving ASHA knowledge can help children with T1DM in underserved rural settings by empowering early diagnosis, raising community awareness, and enabling timely management. This can minimise complications and improve outcomes.
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References
International Diabetes Federation. Diabetes Atlas. Available from: https://diabetesatlas.org/. Accessed on 1 February 2025.
World Health Organization. Diabetes in India. Available from: https://www.who.int/india/diabetes. Accessed on 1 February 2025.
Pasi R, Ravi KS. Type 1 diabetes mellitus in paediatric age group: a rising endemic. J Fam Med Prim Care. 2022;11(1):27-31.
Soleimanpour SA, Stoffers DA. The pancreatic β cell and type 1 diabetes: innocent bystander or active participant? Trends Endocrinol Metab. 2013;24(7):324-31 DOI: https://doi.org/10.1016/j.tem.2013.03.005
CDC. About Insulin Resistance and Type 2 Diabetes. Available from: https://www.cdc.gov/diabetes/about/insulin-resistance-type-2-diabetes.html. Accessed on 1 February 2025.
Pasi R, Ravi KS. Type 1 diabetes mellitus in paediatric age group: a rising endemic. J Fam Med Prim Care. 2022;11(1):27-31. DOI: https://doi.org/10.4103/jfmpc.jfmpc_975_21
https://diabetesatlas.org/idfawp/resource-files/2022/12/IDF-T1D-Index-Report.pdf2. Wayback Machine. web.archive.org. [cited 2024 Jul 2]. Available from: https://web.archive.org/web/20170727161919/ (1).
Das AK. Type 1 diabetes in India: Overall insights. Indian J Endocrinol Metab. 2015;19:S31-3. DOI: https://doi.org/10.4103/2230-8210.155372
Gong B, Yang W, Xing Y, Lai Y, Shan Z. Global, regional, and national burden of type 1 diabetes in adolescents and young adults. Pediatr Res. 2024:1-9. DOI: https://doi.org/10.1038/s41390-024-03107-5
https://diabetesatlas.org/idfawp/resource-files/2022/12/IDF-T1D-Index-Report.pdf5.
International Diabetes Federation. Diabetes around the World in 2021. IDF Diabetes Atlas. 2022. Available from: https://diabetesatlas.org/ (6). Accessed on 1 February 2025.
Kumar KM, Saboo B, Rao PV, Sarda A, Viswanathan V, Kalra S, et al. Type 1 diabetes: awareness, management and challenges: current scenario in India. Indian J Endocrinol Metab. 2015;19(Suppl 1):S6-8. DOI: https://doi.org/10.4103/2230-8210.155339
White NH. Long-term outcomes in youths with diabetes mellitus. Pediatr Clin North Am. 2015;62(4):889-909. DOI: https://doi.org/10.1016/j.pcl.2015.04.004
Rohilla L, Gujjar N, Kaur G, Walia P, Dayal D. Financial burden for families of children with type 1 diabetes: a cross-sectional survey from North India. Diabetol Int. 2022;13(4):665-71. DOI: https://doi.org/10.1007/s13340-022-00589-8
National Health Mission. ASHA. Available from: https://nhm.karnataka.gov.in/page/COMMUNITY+MONITORING/ASHA/en. Accessed on 1 February 2025.
Arora M. Reduced burden on urban hospitals by strengthening rural health facilities: Perspective from India. J Fam Med Prim Care. 2024;13(4):1178-82. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1561_23
UNICEF. Helping Frontline Health Workers Make a Difference. Available from: https://www.unicef.org/india/stories/helping-frontline-health-workers-make-difference. Accessed on 2 February 2025.
Beccia C, Hunter B, Birkic V, White M, Manski-Nankervis JA. Have interventions aimed at assisting general practitioners in facilitating earlier diagnosis of type 1 diabetes in children been successful? A systematic review protocol. BMJ Open. 2023;13(12):e076459. DOI: https://doi.org/10.1136/bmjopen-2023-076459
https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes
The Tribunal. Address shortage of medical specialists. Available from: https://www.tribuneindia.com/news/comment/address-shortage-of-medical-specialists-473709/. Accessed on 2 February 2025.
Literacy and Education. Women and Men in India. 2016. Available from: https://mospi.gov.in/sites/default/files/reports_and_publication/statistical_publication/social_statistics/WM16Chapter3.pdf. Accessed on 2 February 2025.
Kumar DL, Mittal R, Bhalla A, Kumar A, Madan H, Pandhi K, et al. Knowledge and awareness about diabetes mellitus among urban and rural population attending a tertiary care hospital in Haryana. Cureus. 2023;15(4):e38359. DOI: https://doi.org/10.7759/cureus.38359
Khadilkar AV, Oza C, Mondkar SA, Khadilkar V, Kanungo A, Sethi BK, et al. Nutritional status of underprivileged indian children and youth with type-1 diabetes - a multicentre study. Indian J Endocrinol Metab. 2023;27(3):216-22. DOI: https://doi.org/10.4103/ijem.ijem_224_22
Luo D, Cai X, Wang H, Wang Y, Xu J. The role of peer social relationships in psychological distress and quality of life among adolescents with type 1 diabetes mellitus: a longitudinal study. BMC Psychiatr. 2024;24(1):270. DOI: https://doi.org/10.1186/s12888-024-05692-5
Madhu SV, Shukla P, Kaur T, Dhaliwal RS. Mortality in type 1 diabetes mellitus: a single centre experience from the ICMR- youth onset diabetes registry in India. Diabetes Res Clin Pract. 2024;217:111868. DOI: https://doi.org/10.1016/j.diabres.2024.111868
Cinek O, Slavenko M, Pomahačová R, Venháčová P, Petruželková L, Škvor J, et al. Type 1 diabetes incidence increased during the COVID-19 pandemic years 2020-2021 in Czechia: Results from a large population-based pediatric register. Pediatr Diabetes. 2022;23(7):956-60. DOI: https://doi.org/10.1111/pedi.13405
Thomas MT, George MV, Devi ES. A study to assess the effectiveness of a planned teaching programme on diabetes mellitus and its management among ASHA workers in selected areas of Udupi District, Karnataka. J Health Allied Sci NU. 2016;6(02):031-4. DOI: https://doi.org/10.1055/s-0040-1708637
Jain V, Joshi R, Idiculla J, Xavier D. Community health worker interventions in type 2 diabetes mellitus patients: assessing the feasibility and effectiveness in rural central India. J Cardiovasc Disease Res. 2018; 9(3):127-33. DOI: https://doi.org/10.5530/jcdr.2018.3.29
Gudlavalleti AG, Babu GR, Agiwal V, Murthy GVS, Schaper NC, van Schayck OCP. Undesirable levels of practice behaviours and associated knowledge amongst community health workers in rural south India responsible for type 2 diabetes screening and management. Int J Environ Res Public Health. 2024;21(5):562. DOI: https://doi.org/10.3390/ijerph21050562
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