Despite the Ethiopian government's focus on non-communicable diseases, diabetes is
increasingly becoming a major public health issue among adults. Unfortunately, diabetes
care in numerous countries, including Ethiopia, is inadequate, resulting in undiagnosed
cases, low rates of diabetes control, and failure to meet established care standards.
Insufficient readiness of healthcare services, inadequate training of healthcare
professionals, and a lack of patient-centered interventions have contributed to
inadequate healthcare coverage and suboptimal self-management behavior. The inadequate
adherence to self-management behavior has become a critical issue, with half of the
patients failing to comply in Ethiopia. Several systematic reviews and meta-analyses
consistently indicate that the range for achieving good diabetes self-management behavior
is between 49.8% and 51.12%.
To ensure the provision of high-quality diabetes care, it is vital to prioritize patient
preferences and needs by adopting a patient-centered approach. The implementation of
community-based care programs that prioritize patient-centeredness and aim to enhance
patients' understanding of self-care management is of utmost importance. Published
evidence strongly indicates that educational interventions can play a significant role in
supporting individuals with diabetes to improve their self-care management.
The existing delivery approaches in various countries, including Ethiopia, are
insufficient in facilitating the adoption of recommended self-care practices. Therefore,
there is an urgent need to implement patient-centered care programs at the community
level. To address this issue, a Health Extension Worker-Led club-based intervention has
been introduced as a strategic intervention approach to fill this gap. The Health
Extension Worker-led club-based intervention is seamlessly integrated into the existing
Health Extension Program. The introduction of a community-based intervention has a
significant impact on self-management behavior, improves access to chronic disease
services, and enhances outcomes for individuals with chronic diseases.
To the best of our knowledge, there is a lack of evidence regarding the impact of a
Health Extension Worker-led club based intervention on self-management behaviors in
Ethiopia. Therefore, the objective of this study is to assess the impact of the Health
Extension Worker (HEW)-led club-based intervention on improving self-management
behaviors, glycemic control, and the acceptance of the intervention among individuals
with diabetes in Ethiopia.
