Impediments to diabetes management among older women: A qualitative study from rural Meghalaya,India

Abstract

Objectives

This study aims to explore the impediments to diabetes management among older women living in rural areas of Meghalaya, a northeastern state in India.

Methods

The study adopted a narrative inquiry approach. In-depth interviews were conducted with 29 older women (aged 60 and above), selected purposively. Findings were analyzed thematically using the open or inductive coding approach in NVivo 12.0.

Results

Seven key themes emerged from the study. These were: (i) negative impacts of physiological changes on diabetes management for the participants, (ii) weak social support which hindered diabetes care, (iii) experiences of ill-treatment by relatives and a sense of helplessness, (iv) caregiving roles as barriers to care, (v) difficulties in accessing treatment due to geographical barriers, (vi) expensive treatment due to comorbidities, and (vii) feelings of guilt due to financial dependency.

Conclusions

Our study found a confluence of structural and individual-level barriers that hindered diabetes management among older women in rural Meghalaya. These barriers were linked not only to age and disease but also to gendered social roles, systemic health care gaps, and economic insecurity. This study emphasises the need to reinforce current healthcare policies and programmes targeting older women and to advocate for a comprehensive, multisectoral approach to address these issues effectively.