“They say eating carbohydrates or sugar” – Perceptions and daily experiences of people living with diabetes and hypertension in Lagos, Nigeria

Purpose: While research has examined the prevalence of hypertension and diabetes in sub-Saharan Africa, few studies have examined patients' management of these conditions in such limited resource settings. The purpose of this study was to explore patients' perceptions and daily experiences in managing diabetes and hypertension among a clinic-based sample in Lagos, Nigeria. Methods: Forty semi-structured interviews were conducted with patients seeking care for hypertension and/or diabetes at a primary care clinic in Lagos Nigeria in 2009. Interviews were conducted in English, and using the PEN-3 cultural model, interview questions explored participants' perceptions about causes and treatment of hypertension and diabetes, family role in disease management efforts, and their experiences in managing the conditions on a daily basis. Analysis was guided by the PEN-3 model and content analysis was used to identify emergent themes. Results: Participants' average age was 57 years and over 50% were females (26). Over a third (14) had co-morbid hypertension and diabetes. Majority believed that diabetes was caused by sugar or sugary foods, while some believed that hypertension was caused by “working and worrying”, and some believed it was caused by “drinking too much and living a reckless life.” Majority of the participants seek western treatment, although some also use traditional medicine. Most participants expressed receiving support from family members. Issues related to access to medical care, cost of medication, and following physician's advice also emerged. Conclusions: Understanding patients' perceptions and daily experiences in managing hypertension and diabetes in Nigeria can provide insights for intervention efforts