Skip to main content
Top
Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Type 1 Diabetes | Research

Living with type 1 diabetes and schooling among young people in Ghana: a truism of health selection, inadequate support, or artefactual explanation of educational inequalities?

Authors: Bernard Afriyie Owusu, David Teye Doku

Published in: BMC Public Health | Issue 1/2024

Login to get access

Abstract

Introduction

Type 1 diabetes mellitus (T1DM) is mostly diagnosed among young people. Despite the evidence that T1DM is disruptive, and affects individuals’ health and cognitive ability, there is dearth of knowledge on the impact of T1DM on schooling in LMICs including Ghana. In this research, we explored the impact of T1DM on the schooling of young people living with the disease, and discussed the results within health selection, social support, and artefactual perspectives of inequality.

Methods

Data were extracted from a qualitative project on T1DM lived experiences in southern Ghana. The study participants were young persons living with T1DM (n = 28) and their caregivers (n = 12). They were purposively recruited to participate in the study using maximum variation and snowball sampling techniques and interviewed in their support group centres, homes, or healthcare facilities using semi-structured interview guides. A computer-assisted qualitative data analysis was performed using QSR NVivo 14 software, and the results were categorised into themes.

Results

Three themes were identified from the transcripts. These themes were school and classroom attendance, choice of school, and school/academic performance. T1DM was a major reason for patients’ limited contact hours with teachers, school drop-out, preference for day schools rather than boarding, opting for vocational training instead of continuation of formal education, limited concentration at school, and delayed educational progression.

Conclusion

T1DM impacted the schooling of young people living with the disease. The mechanisms of these impacts, and young peoples lived experiences are not artefactual, but rather support discourses on health selection and inadequate social support for young people living with the disease. The results call for the need to develop educational and social interventions to address these barriers. The full implementation of the Inclusive Education Policy (IEP) may contribute to reducing educational and social inequalities caused by ill-health.
Appendix
Available only for authorised users
Literature
1.
go back to reference Gregory GA, Robinson TI, Linklater SE, Wang F, Colagiuri S, de Beaufort C, Donaghue KC, Magliano DJ, Maniam J, Orchard TJ, Rai P. Global incidence, prevalence, and mortality of type 1 diabetes in 2021 with projection to 2040: a modelling study. Lancet Diabetes Endocrinol. 2022;10(10):741–60.CrossRefPubMed Gregory GA, Robinson TI, Linklater SE, Wang F, Colagiuri S, de Beaufort C, Donaghue KC, Magliano DJ, Maniam J, Orchard TJ, Rai P. Global incidence, prevalence, and mortality of type 1 diabetes in 2021 with projection to 2040: a modelling study. Lancet Diabetes Endocrinol. 2022;10(10):741–60.CrossRefPubMed
2.
go back to reference Ogle GD, James S, Dabelea D, Pihoker C, Svennson J, Maniam J, Klatman EL, Patterson CC. Global estimates of incidence of type 1 diabetes in children and adolescents: Results from the International Diabetes Federation Atlas. Diabetes Res Clin Pract. 2022;1(183):109083.CrossRef Ogle GD, James S, Dabelea D, Pihoker C, Svennson J, Maniam J, Klatman EL, Patterson CC. Global estimates of incidence of type 1 diabetes in children and adolescents: Results from the International Diabetes Federation Atlas. Diabetes Res Clin Pract. 2022;1(183):109083.CrossRef
6.
go back to reference Persson S, Dahlquist G, Gerdtham UG, Steen CK. Impact of childhood-onset type 1 diabetes on schooling: a population-based register study. Diabetologia. 2013;56:1254–62.CrossRefPubMed Persson S, Dahlquist G, Gerdtham UG, Steen CK. Impact of childhood-onset type 1 diabetes on schooling: a population-based register study. Diabetologia. 2013;56:1254–62.CrossRefPubMed
7.
go back to reference McCarthy AM, Lindgren S, Mengeling M, Tsalikian E. Effects of diabetes on learning in children. Diabetes Res Clin Pract. 2000;50:229.CrossRef McCarthy AM, Lindgren S, Mengeling M, Tsalikian E. Effects of diabetes on learning in children. Diabetes Res Clin Pract. 2000;50:229.CrossRef
8.
go back to reference Owusu BA, Ofori-Boateng P, Forbes A, Doku DT. Knowledge of young people living with type 1 diabetes and their caregivers about its management. Nursing Open. 2023;10(4):2426-38. Owusu BA, Ofori-Boateng P, Forbes A, Doku DT. Knowledge of young people living with type 1 diabetes and their caregivers about its management. Nursing Open. 2023;10(4):2426-38.
9.
go back to reference Ministry of Education. Inclusive Education Policy. Ministries, Accra-Ghana. 2015. Ministry of Education. Inclusive Education Policy. Ministries, Accra-Ghana. 2015.
10.
go back to reference Yu SL, Kail R, Hagen JW, Wolters CA. Academic and social experiences of children with insulin-dependent diabetes mellitus. Child Health Care. 2000;29(3):189–207.CrossRef Yu SL, Kail R, Hagen JW, Wolters CA. Academic and social experiences of children with insulin-dependent diabetes mellitus. Child Health Care. 2000;29(3):189–207.CrossRef
11.
go back to reference Glaab LA, Brown R, Daneman D. School attendance in children with type 1 diabetes. Diabet Med. 2005;22(4):421–6.CrossRefPubMed Glaab LA, Brown R, Daneman D. School attendance in children with type 1 diabetes. Diabet Med. 2005;22(4):421–6.CrossRefPubMed
12.
go back to reference Oakley NJ, Kneale D, Mann M, Hilliar M, Dayan C, Gregory JW, French R. Type 1 diabetes mellitus and educational attainment in childhood: a systematic review. BMJ Open. 2020;10(1):e033215.CrossRefPubMedPubMedCentral Oakley NJ, Kneale D, Mann M, Hilliar M, Dayan C, Gregory JW, French R. Type 1 diabetes mellitus and educational attainment in childhood: a systematic review. BMJ Open. 2020;10(1):e033215.CrossRefPubMedPubMedCentral
13.
go back to reference Warren JR. Socioeconomic status and health across the life course: A test of the social causation and health selection hypotheses. Soc Forces. 2009;87(4):2125–53.CrossRefPubMedPubMedCentral Warren JR. Socioeconomic status and health across the life course: A test of the social causation and health selection hypotheses. Soc Forces. 2009;87(4):2125–53.CrossRefPubMedPubMedCentral
14.
go back to reference Elstad JI. Health-related mobility, health inequalities and gradient constraint Discussion and results from a Norwegian study. The European Journal of Public Health. 2001;11(2):135–40.CrossRefPubMed Elstad JI. Health-related mobility, health inequalities and gradient constraint Discussion and results from a Norwegian study. The European Journal of Public Health. 2001;11(2):135–40.CrossRefPubMed
15.
go back to reference Power C, Matthews S, Manor O. Inequalities in self rated health in the 1958 birth cohort: lifetime social circumstances or social mobility? BMJ. 1996;313(7055):449–53.CrossRefPubMedPubMedCentral Power C, Matthews S, Manor O. Inequalities in self rated health in the 1958 birth cohort: lifetime social circumstances or social mobility? BMJ. 1996;313(7055):449–53.CrossRefPubMedPubMedCentral
16.
go back to reference Meo SA, Alkahlan MA, Al-Mubarak MA, Al-Obayli MS, Melaibary BA, Dous AN, Alhassoun AI. Impact of type 1 diabetes mellitus on academic performance. J Int Med Res. 2013;41(3):855–8.CrossRefPubMed Meo SA, Alkahlan MA, Al-Mubarak MA, Al-Obayli MS, Melaibary BA, Dous AN, Alhassoun AI. Impact of type 1 diabetes mellitus on academic performance. J Int Med Res. 2013;41(3):855–8.CrossRefPubMed
17.
go back to reference Bowden N, Dixon R, Anderson V, de Bock M, Boucsein A, Kewene-Edwards M, Gibb S, Kokaua J, Palmer O, Paul R, Taylor B. Associations between type 1 diabetes and educational outcomes: an Aotearoa/New Zealand nationwide birth cohort study using the Integrated Data Infrastructure. Diabetologia. 2023;23:1–2. Bowden N, Dixon R, Anderson V, de Bock M, Boucsein A, Kewene-Edwards M, Gibb S, Kokaua J, Palmer O, Paul R, Taylor B. Associations between type 1 diabetes and educational outcomes: an Aotearoa/New Zealand nationwide birth cohort study using the Integrated Data Infrastructure. Diabetologia. 2023;23:1–2.
18.
go back to reference Fleming M, Fitton CA, Steiner MF, McLay JS, Clark D, King A, Lindsay RS, Mackay DF, Pell JP. Educational and health outcomes of children treated for type 1 diabetes: Scotland-wide record linkage study of 766,047 children. Diabetes Care. 2019;42(9):1700–7.CrossRefPubMed Fleming M, Fitton CA, Steiner MF, McLay JS, Clark D, King A, Lindsay RS, Mackay DF, Pell JP. Educational and health outcomes of children treated for type 1 diabetes: Scotland-wide record linkage study of 766,047 children. Diabetes Care. 2019;42(9):1700–7.CrossRefPubMed
19.
go back to reference Aikins AD, Owusu-Dabo E, Agyemang C. Diabetes in Ghana: a review of research on prevalence, experiences and healthcare. Chronic Non-Communicable Diseases in Ghana. Multidisciplin Perspect. 2013;1:41–55. Aikins AD, Owusu-Dabo E, Agyemang C. Diabetes in Ghana: a review of research on prevalence, experiences and healthcare. Chronic Non-Communicable Diseases in Ghana. Multidisciplin Perspect. 2013;1:41–55.
20.
go back to reference Essuman VA, Tagoe NN, Akpalu J, Essuman A, Sackey AH, Hayfron-Benjamin CF, Asare G, Abaidoo B, Amoah AG, Ndanu T, Ofori-Adjei ID. Morbidity and complications of diabetes mellitus in children and adolescents in Ghana: Protocol for a longitudinal study. JMIR research protocols. 2021;10(1):e21440.CrossRefPubMedPubMedCentral Essuman VA, Tagoe NN, Akpalu J, Essuman A, Sackey AH, Hayfron-Benjamin CF, Asare G, Abaidoo B, Amoah AG, Ndanu T, Ofori-Adjei ID. Morbidity and complications of diabetes mellitus in children and adolescents in Ghana: Protocol for a longitudinal study. JMIR research protocols. 2021;10(1):e21440.CrossRefPubMedPubMedCentral
21.
go back to reference Rasmussen B, Ward G, Jenkins A, King SJ, Dunning T. Young adults’ management of Type 1 diabetes during life transitions. J Clin Nurs. 2011;20(13–14):1981–92.CrossRefPubMed Rasmussen B, Ward G, Jenkins A, King SJ, Dunning T. Young adults’ management of Type 1 diabetes during life transitions. J Clin Nurs. 2011;20(13–14):1981–92.CrossRefPubMed
22.
go back to reference Owusu BA, Ofori-Boateng P, Doku DT. Coping and adaptation strategies among young persons living with type 1 diabetes and their caregivers: textual and photovoice analyses. BMC Public Health. 2023;23(1):1684.CrossRefPubMedPubMedCentral Owusu BA, Ofori-Boateng P, Doku DT. Coping and adaptation strategies among young persons living with type 1 diabetes and their caregivers: textual and photovoice analyses. BMC Public Health. 2023;23(1):1684.CrossRefPubMedPubMedCentral
23.
go back to reference Tomic D, Craig ME, Magliano DJ, Shaw JE. Reasons for hospitalisation in youth with type 1 diabetes, 2010–2019. Diabetic medicine: a journal of the British Diabetic Association. 2023;31:e15218. Tomic D, Craig ME, Magliano DJ, Shaw JE. Reasons for hospitalisation in youth with type 1 diabetes, 2010–2019. Diabetic medicine: a journal of the British Diabetic Association. 2023;31:e15218.
24.
go back to reference Angus VC, Waugh N. Hospital admission patterns subsequent to diagnosis of type 1 diabetes in children: a systematic review. BMC Health Serv Res. 2007;7:1.CrossRef Angus VC, Waugh N. Hospital admission patterns subsequent to diagnosis of type 1 diabetes in children: a systematic review. BMC Health Serv Res. 2007;7:1.CrossRef
25.
go back to reference McCollum DC, O’Grady MJ. Diminished school-based support for the management of type 1 diabetes in adolescents compared to younger children. Diabet Med. 2020;37(5):779–84.CrossRefPubMed McCollum DC, O’Grady MJ. Diminished school-based support for the management of type 1 diabetes in adolescents compared to younger children. Diabet Med. 2020;37(5):779–84.CrossRefPubMed
26.
go back to reference Kratzer J. Structural barriers to coping with type 1 diabetes mellitus in Ghana: experiences of diabetic youth and their families. Ghana Med J. 2012;46(2):39–45.PubMedPubMedCentral Kratzer J. Structural barriers to coping with type 1 diabetes mellitus in Ghana: experiences of diabetic youth and their families. Ghana Med J. 2012;46(2):39–45.PubMedPubMedCentral
27.
go back to reference Garvey KC, Wolpert HA. Identifying the unique needs of transition care for young adults with type 1 diabetes. Diabetes Spectrum. 2011;24(1):22–5.CrossRef Garvey KC, Wolpert HA. Identifying the unique needs of transition care for young adults with type 1 diabetes. Diabetes Spectrum. 2011;24(1):22–5.CrossRef
28.
go back to reference Nakhla M, Daneman D, To T, Paradis G, Guttmann A. Transition to adult care for youths with diabetes mellitus: findings from a Universal Health Care System. Pediatrics. 2009;124(6):e1134–41.CrossRefPubMed Nakhla M, Daneman D, To T, Paradis G, Guttmann A. Transition to adult care for youths with diabetes mellitus: findings from a Universal Health Care System. Pediatrics. 2009;124(6):e1134–41.CrossRefPubMed
29.
go back to reference Mitchell RJ, McMaugh A, Woodhead H, Lystad RP, Zurynski Y, Badgery-Parker T, Cameron CM, Hng TM. The impact of type 1 diabetes mellitus in childhood on academic performance: A matched population-based cohort study. Pediatr Diabetes. 2022;23(3):411–20.CrossRefPubMedPubMedCentral Mitchell RJ, McMaugh A, Woodhead H, Lystad RP, Zurynski Y, Badgery-Parker T, Cameron CM, Hng TM. The impact of type 1 diabetes mellitus in childhood on academic performance: A matched population-based cohort study. Pediatr Diabetes. 2022;23(3):411–20.CrossRefPubMedPubMedCentral
30.
go back to reference Morone JF, Teitelman AM, Cronholm PF, Hawkes CP, Lipman TH. Influence of social determinants of health barriers to family management of type 1 diabetes in Black single parent families: a mixed methods study. Pediatr Diabetes. 2021;22(8):1150–61.CrossRefPubMed Morone JF, Teitelman AM, Cronholm PF, Hawkes CP, Lipman TH. Influence of social determinants of health barriers to family management of type 1 diabetes in Black single parent families: a mixed methods study. Pediatr Diabetes. 2021;22(8):1150–61.CrossRefPubMed
31.
go back to reference King KM, King PJ, Nayar R, Wilkes S. Perceptions of adolescent patients of the “lived experience” of type 1 diabetes. Diabetes Spectrum. 2017;30(1):23–35.CrossRefPubMedPubMedCentral King KM, King PJ, Nayar R, Wilkes S. Perceptions of adolescent patients of the “lived experience” of type 1 diabetes. Diabetes Spectrum. 2017;30(1):23–35.CrossRefPubMedPubMedCentral
32.
go back to reference Ahmed AA, Burbur AA, Babiker SM, Mohamed SO, Elseed ME, Saad FM. Impact of type 1 diabetes mellitus on the academic performance of diabetic school children in Khartoum, Sudan. Sudanese J Paediatr. 2021;21(2):123.CrossRef Ahmed AA, Burbur AA, Babiker SM, Mohamed SO, Elseed ME, Saad FM. Impact of type 1 diabetes mellitus on the academic performance of diabetic school children in Khartoum, Sudan. Sudanese J Paediatr. 2021;21(2):123.CrossRef
33.
go back to reference Brands AM, Biessels GJ, De Haan EH, Kappelle LJ, Kessels RP. The effects of type 1 diabetes on cognitive performance: a meta-analysis. Diabetes Care. 2005;28(3):726–35.CrossRefPubMed Brands AM, Biessels GJ, De Haan EH, Kappelle LJ, Kessels RP. The effects of type 1 diabetes on cognitive performance: a meta-analysis. Diabetes Care. 2005;28(3):726–35.CrossRefPubMed
34.
go back to reference Jenkins D, Spence C. The Career Pathways How-To Guide. Workforce Strategy Center. 2006. Jenkins D, Spence C. The Career Pathways How-To Guide. Workforce Strategy Center. 2006.
Metadata
Title
Living with type 1 diabetes and schooling among young people in Ghana: a truism of health selection, inadequate support, or artefactual explanation of educational inequalities?
Authors
Bernard Afriyie Owusu
David Teye Doku
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Type 1 Diabetes
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-18590-y

Other articles of this Issue 1/2024

BMC Public Health 1/2024 Go to the issue