SOCIO-CULTURAL BARRIERS AND FACILITATORS OF ADHERENCE TO GESTATIONAL DIABETES MANAGEMENT AMONG PREGNANT WOMEN IN OSUN STATE, NIGERIA

Abstract

Gestational diabetes mellitus (GDM) is a growing burden on public health and has been linked to adverse outcomes for both mother and neonate, especially when compliance with recommended management is suboptimal. Socio-cultural factors may influence adherence and non-adherence to GDM management among pregnant women in Nigeria, but there is limited empirical evidence from Osun State. This study investigated the extent of adherence and socio-cultural factors influencing gestational adherence and non-adherence among pregnant women in Osun State, Nigeria. A descriptive cross-sectional survey design was adopted for the study. A structured questionnaire was used to collect data from 128 pregnant women attending antenatal care at purposively selected health facilities. Descriptive statistics, Chi-square and binary logistic regression were used to analyse the data at P < 0.05. It was found that 36.7% of the respondents had poor adherence, 33.6% had moderate adherence and 29.7% had good adherence to gestational diabetes management and 53.9% were grouped as non-adherent.  Food practices (=2.75 ± 0.83), stigma (=2.73 ± 0.81), religion/spiritual beliefs (=2.71 ± 0.80), traditional medicine (=2.70 ± 0.79), cultural beliefs (=2. 68 ± 0.78), and family pressure (=2.66 ± 0.80) were considered as key socio-cultural barriers to adherence. Support from family (Mean = 3.01 ±° 0.76), health education (Mean = 2.95 ± 0.79), health care workers (Mean = 2.91 ± 0.81), religious support (Mean = 2.83 ± 0.82), community support (Mean = 2.78 ± 0.80) and financial support (Mean = 2.74 ±0.84) were found to significantly facilitate adherence to GDM management. Binary logistic regression analysis showed that cultural beliefs (OR = 4.10, p = 0.016), family pressure (OR = 2.95, p = 0.033), and religious/spiritual beliefs (OR = 2.57, p = 0.047) were significant predictors of non-adherence. Based on these findings, intervention should be delivered through family-centered, group-based, culturally sensitive, and community-integrated antenatal care framework that strengthens social support networks, enhances health education, promotes adherence to gestational diabetes management, and ultimately improves maternal health outcomes.