Using WhatsApp to improve self-care management among type 2 diabetes patients in Ethiopia: A qualitative study

BackgroundThe prevalence of diabetes in low- and middle-income countries is rising, and the most important treatment is maintaining a healthy lifestyle. Good diabetes self-care management is associated with better outcomes, but barriers to adhering to its management are knowledge deficits and a lack of social support. Traditionally, diabetes self-care management education and support are conducted by health care workers (HCWs), but limited access to HCWs restricts this activity. Digital health interventions can help overcome some barriers. ObjectiveTo describe type 2 diabetic patients perception of using WhatsApp for diabetes education, as well as the barriers and enablers they experienced in their usage, in the Tigray region of Ethiopia. MethodThis study is a collaboration between researchers from Norway and a researcher from Ethiopia. A qualitative explorative and descriptive approach was adopted. The co-researcher in Ethiopia recruited the participants, and research assistants conducted 17 interviews with a semi-structured interview guide based on the technology acceptance model. The interviews were conducted in Tigrinya, transcribed and translated to English, and de-identified before analysis. The data were analysed using NVIVO 14 with reflexive thematic analysis. ResultsFrom the data, the following four themes were developed: experienced enhanced self-care, digital access to HCWs, digital support, and barriers and enablers. The participants perceived WhatsApp as highly useful. The participants said that they gained new knowledge and experienced social support and increased access to HCWs when using WhatsApp. ConclusionWhatsApp was perceived as easy to use, but some barriers were reported. This study indicates that WhatsApp may contribute to enhancing access to diabetes self-care management education and support.