Cultural competency in diabetes management: a qualitative phenomenological study of healthcare providers’ perspectives in Ethiopia

Abstract

Chronic diseases, including diabetes, are significant health challenges globally, particularly in low- and middle-income countries. Diabetes management is profoundly influenced by cultural beliefs and practices of providers and patients, necessitating culturally competent care by the providers to improve health outcomes. This qualitative phenomenological study explores healthcare providers’ perspectives on cultural competency in diabetes care at Tikur Anbesa Specialized Hospital in Ethiopia. A phenomenological qualitative design was employed, using in-depth individual interviews with 7 healthcare providers, including doctors, nurses, and pharmacists. The interview guide was based on Seeleman’s cultural competence model. The data were analyzed thematically, identifying key themes related to cultural competency of providers in diabetes care. Major thematic categories identified included : challenges in delivering culturally competent care due to cultural and religious influences; knowledge gaps in cultural competence; building trust and patient relationships; openness, respect, and curiosity toward patients’ beliefs; communication strategies and language barriers; shared decision-making; cultural competence training needs; and perceptions regarding outcomes. Providers emphasized the necessity of cultural competence training and formal guidelines to better understand and respect diverse cultural beliefs to enhance diabetes care outcomes. The lack of such training hindered effective communication and treatment adherence. Strategies employed by providers—including the use of interpreters and culturally adapted educational materials—highlighted the importance of building trust and fostering open communication. Despite systemic barriers, healthcare providers demonstrated attitudes of openness and respect toward patients’ cultural backgrounds, underscoring the critical need for comprehensive cultural competence training to improve patient engagement and health outcomes. Healthcare providers at Tikur Anbesa Specialized Hospital struggle to deliver culturally competent diabetes care due to inadequate training and resources. Effective communication and understanding of cultural beliefs are essential for improving patient outcomes. Structured cultural competence training programs integrated into healthcare curricula and professional development are crucial to enhance diabetes care and address the unique needs of diverse patient populations.