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. 2025 Dec;18(1):2482304.
doi: 10.1080/16549716.2025.2482304. Epub 2025 Apr 9.

Feasibility and impact of a patient support group care model on diabetes and hypertension care in informal settlements in Nairobi, Kenya: a quasi-experimental study

Richard E Sanya  1 , Caroline H Karugu  1   2 , Samuel Iddi  1 , Peter M Kibe  1 , Lilian Mburu  1 , Lilian Mbau  3 , Victor Kibe  4 , Sloan Mahone  5 , Naomi S Levitt  6 , Kerstin Klipstein-Grobusch  7   8 , Gershim Asiki  1   9
Affiliations

Feasibility and impact of a patient support group care model on diabetes and hypertension care in informal settlements in Nairobi, Kenya: a quasi-experimental study

Richard E Sanya et al. Glob Health Action. 2025 Dec.

Abstract

Background: A support group care model including self-financing is a promising strategy to improve care for patients with diabetes or hypertension in resource-constrained settings.

Objectives: We investigated the uptake, feasibility, and impact of a self-financing patient support group care model on cardiometabolic parameters among adult patients with uncontrolled diabetes or hypertension in informal settlements in Nairobi, Kenya.

Methods: A two-group prospective quasi-experimental study was conducted. The outcomes were changes in mean glycated haemoglobin (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index, and waist-hip ratio in control versus intervention communities, assessed 6 months after intervention implementation.

Results: At baseline, 118 patients with diabetes (intervention, 60; control, 58) and 176 with hypertension (intervention, 87; control, 89) were enrolled. At endline, 81 patients with diabetes and 137 with hypertension were surveyed. In the intervention arm, HbA1c decreased from 10.8% to 9.0% (mean difference [95% CI]: -1.7 [-2.4, -0.9] p < 0.001) and in the control arm from 10.6% to 9.9% (-0.9 [-1.5, -0.3] p = 0.005). Difference-in-difference analysis showed a notably greater reduction in HbA1c in the intervention arm (-0.942 [0.463] p < 0.05). In the intervention arm, SBP decreased from 155.0 mmHg to 148.7 mmHg (-6.3 [-11.7, -0.9] p = 0.022) and in the control arm, from 160.1 mmHg to 152.5 mmHg (-7.6 [-12.9, -2.3] p = 0.005). DBP in the intervention arm changed from 99.1 mmHg to 97.9 mmHg (-1.1 [4.2, 1.9] p = 0.462) and in the control arm from 99.7 mmHg to 94.8 mmHg (-4.9 [7.8, -2.0] p = 0.001).

Conclusions: A self-financing patient support group care model is feasible, improves cardiometabolic parameters and can be a strategy to manage diabetes, hypertension, and other chronic diseases in low-resource settings.

Keywords: Africa; Hypertension; diabetes; low- and middle-income countries; patient support groups; self-financing.

Plain language summary

Main findings: A co-created self-financing patient support group care model tested for 6 months among patients with uncontrolled diabetes or hypertension in informal settlements in Nairobi, Kenya, resulted in substantial reductions in glycated haemoglobin and blood pressure.Added knowledge: A self-financing patient support group care model for diabetes and hypertension is feasible and can impact disease outcomes in low-resource settings.Global health impact for policy and action: The self-financing patient support group care model is an additional toolkit to manage diabetes and hypertension in resource-limited settings and can be adapted for other chronic diseases.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s)s.

Figures

Figure 1.
Figure 1.
Self-financing patient support group care model for hypertension and diabetes.
Figure 2.
Figure 2.
Flowchart of the quasi-experimental study to investigate the impact of the self-financing patient support group care model on individuals with uncontrolled hypertension or diabetes.
See this image and copyright information in PMC

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