Diabetes is significantly associated with increased COVID-19 severity, hospitalisation, and mortality globally. Given that 79% of people with diabetes live in low- and middle-income countries (Diabetes IDF 9th edition, 2019), the COVID-19 impact on diabetes is significantly higher among these countries including Uganda. For instance, the report released by the Ministry of Health Uganda in September 2020 suggested that nearly 80% of COVID-19 deaths were among people with diabetes.
The pandemic has also disrupted diabetes services that were already weaker among the rural poor and older people. The impact on the diabetes services and self-monitoring was twofold: Firstly, COVID-19 directly impacted the import of medical and self-monitoring essentials to Uganda that distorted the supply chain. Secondly, the strict lockdown created access barriers for people with diabetes. For instance, people with diabetes from rural areas were unable to travel to the health centres to access medical supplies including insulin during the lockdown. In addition, loss of income resulted in reduced affordability of transport to access diabetes services.
The project has three components that look into the impact of COVID-19 on people with diabetes at multiple levels.
First, under the direction of supervisors Guntupalli and Mody, the student will conduct a review of evidence on the impact of COVID-19 on the mortality, severe morbidity, and hospitalisation among people with diabetes in Uganda. In addition, a questionnaire will be designed to further understand the scale of COVID-19 impact on people with diabetes in rural Uganda particularly the districts of Isingiro-Ntungamo-Sheema Districts where there are data gaps. The Uganda supervisor Bahendeka will be supporting the data collection process.
Second, with the guidance of supervisor Sara Maclennan the student will carry out a qualitative study to understand the impact of COVID-19 on the care pathway of people with diabetes from rural areas. This part of the study will interview health workers at all levels from community health settings to tertiary care settings to explore the barriers faced by health providers in providing treatment and care to people with diabetes. The Uganda supervisor Silver will also be overseeing this part of the study.
Third, under the direction of supervisors Mody and Guntupalli, the student will study the impact of the COVID-19 pandemic on self-management of diabetes in rural settings. This aspect of work will involve interviewing people with diabetes living in rural areas to study the barriers they faced in self-management of diabetes during the pandemic.
The project will contribute to the ongoing health system strengthening work carried out by our research group to combat non-communicable diseases in LMICs including Uganda. In particular, the proposed work will suggest the ways healthcare providers have to adapt during pandemics and disasters in order to meet the requirements of the rural Ugandans who might be disproportionately poorer and older.
APPLICATION PROCEDURE:
This project is advertised in relation to the research areas of APPLIED HEALTH SCIENCE. Formal applications can be completed online:
https://www.abdn.ac.uk/pgap/login.php. You should apply for Degree of Doctor of Philosophy in Applied Health Science, to ensure that your application is passed to the correct person for processing.
NOTE CLEARLY THE NAME OF THE SUPERVISOR AND EXACT PROJECT TITLE ON THE APPLICATION FORM.
Applicants are limited to applying for a maximum of 3 applications for funded projects. Any further applications received will be automatically withdrawn.
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