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. 2025 Jul 28:11:20552076251349705.
doi: 10.1177/20552076251349705. eCollection 2025 Jan-Dec.

Beyond individual barriers and facilitators: Digital interventions to address diabetes in urban Ghana

Ethan Gray  1   2 , Ann Blandford  2 , Samuel Amon  3 , Publa Antwi  4 , Vida Asah-Ayeh  3 , Raphael Baffour Awuah  5   6 , Leonard Baatiema  7 , Sandra Boatemaa Kushitor  3 , Hassan Haghparast-Bidgoli  1 , Hannah Maria Jennings  4   8 , Irene Akwo Kretchy  9 , Daniel Strachan  10 , Megan Vaughan  11 , Edward Fottrell  1
Affiliations

Beyond individual barriers and facilitators: Digital interventions to address diabetes in urban Ghana

Ethan Gray et al. Digit Health. .

Abstract

Objective: The prevalence of type 2 diabetes (T2D) and other non-communicable diseases (NCDs) in Ghana and other countries in sub-Saharan Africa (SSA) is increasing at a rate notably higher than the rest of the world. Consequently, there is an urgent need to develop low-cost community interventions for diseases including T2D in Ghana, with digital tools potentially empowering community members in prevention and management. This research aimed to identify effective strategies for leveraging digital tools to address T2D in Ga Mashie, Ghana, through community-driven empowerment and action.

Method: This was a mixed methods study involving focus groups (N = 13), qualitative interviews with community representatives (N = 69) and two community workshops (N = 35 participants in each).

Results: The focus groups and interviews identified strong facilitators for an individual-level digital intervention focused on education; however, workshops highlighted that the community wants greater access to in-person education and healthcare services in Ga Mashie, limiting the likely impact of an individual digital intervention.

Conclusion: Our findings challenge the widespread assumption that digital interventions should be targeted at the individual; rather, digital tools might be used to empower community leaders in Ga Mashie with training and clinical guidance to function as healthcare agents, scaling-up the delivery of education and screening services to their broader community. This suggests a novel system-level strategy for designing community-based, empowerment-focused digital health interventions that reflect the practices and values of community members, though further work is needed to validate this approach.

Keywords: Digital health; community health; empowerment; mHealth; non-communicable diseases; task-shifting; type 2 diabetes.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Diagram showing individual- and system-level digital innovations.
Figure 2.
Figure 2.
Primary solution strategies proposed by the community.
Figure 3.
Figure 3.
Proposed strategies for leveraging digital tools to empower community agents to address T2D in Ga Mashie.
See this image and copyright information in PMC

References

    1. Atun R, Davies JI, Gale EAM, et al. Diabetes in sub-Saharan Africa: from clinical care to health policy. Lancet Diabetes Endocrinol 2017; 5: 622–667. - PubMed
    1. Asamoah-Boaheng M, Sarfo-Kantanka O, Tuffour AB, et al. Prevalence and risk factors for diabetes mellitus among adults in Ghana: a systematic review and meta-analysis. Int Health 2019; 11: 83–92. - PubMed
    1. Kazibwe J, Gad M, Abassah-Konadu E, et al. The epidemiological and economic burden of diabetes in Ghana: A scoping review to inform health technology assessment. medRxiv 2023. Apr. - PMC - PubMed
    1. Amoah AGB, Owusu SK, Adjei S. Diabetes in Ghana: a community-based prevalence study in Greater Accra. Diabetes Res Clin Pract 2002; 56: 197–205. - PubMed
    1. Aikins AD-G, Kushitor M, Koram K, et al. Chronic non-communicable diseases and the challenge of universal health coverage: insights from community-based cardiovascular disease research in urban poor communities in Accra, Ghana. BMC Public Health 2014; 14: 1–9. - PMC - PubMed

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