Social Characterization of Programs for the Control of Type Two Diabetes Mellitus and Hypertension in Cali - Colombia 2014 - 2015. A qualitative approach to understand adherence

Objectives: General Objective: reconstruct, describe and analyze the social programs oriented to control of Type Two Diabetes Mellitus (DM2) and high blood pressure (hypertension) in Cali at diverse health agencies from the voice of those who coordinate and implement the programs.
Methods: An ethnographic qualitative study was conducted using partial structured interviews, non-participant observation and documental analysis. By using a stratified convenience sample, three Health provider Services (EPS) were selected and 42 health professional working in the programs chosen. Three groups of professionals were formed, one for each kind of Health affiliation system being 1) subsidized, the second to the contributory scheme, and the third to the special regime. All professionals interview belong to the prepaid health care system.
Results: Programs are mainly design to monitor and interfere the progress of individual clinical complications. Programs include interdisciplinary professional teams, responsible for educating patients about the urgency to change their daily life styles and practices. However, the programs fail to address important social determinants that include also family bonds making difficult to offer integrated solutions.
Conclusions: The findings allow a better understanding of the social complexity linked to HTA and DM2. The study reveals that a pharmacologic approach is predominant to address HTA and DM2. Transform it into a life style initiative approach can result in better technical guidelines to increase patient compliance.