Patient Perspectives on Barriers to Diabetes Management and the Affordability of Care in Ilorin, Kwara State, Nigeria

Abstract

Diabetes Mellitus (DM) continues to pose a growing public health concern, with the increasing prevalence worsened by socio-economic and healthcare system constraints in Nigeria. Among the key barriers to effective DM care, affordability is a major challenge. This study aimed to assess patients’ perspectives on the affordability of DM care and identify barriers and sociodemographic factors influencing access to effective care in a tertiary healthcare facility. A descriptive cross-sectional study was conducted from June to August 2024 at the University of Ilorin Teaching Hospital among 165 adult DM patients using systematic random sampling. Data were collected through structured interviewer- administered questionnaires, and analysed using SPSS version 22.0, with statistical significance set at p < 0.05. Nearly half, (49.1%) of the respondents were between 46–60 years old, with a female predominance (57.6%). The majority (88.5%) had Type 2 DM. Notably, over two-thirds (68.5%) of respondents indicated that DM care was unaffordable. The major barriers identified included treatment costs (53.3%) and transportation burdens (35.2%). Affordability was significantly associated with age, marital status, education, and employment status (p < 0.05), while gender and having health insurance were not. Furthermore, high treatment costs, transportation expenses, and delayed salary payments were significantly linked to reduced hospital visits. In conclusion, the study revealed that affordability is a major barrier to effective DM care in Nigeria. Hence, there is a need to enhance access to affordable care by expanding health insurance coverage, strengthening healthcare infrastructure, improving quality, and subsidizing DM care