Table 2 Systemic barriers of adherence to medical advice among diabetic patients

Systemic problems

Inadequate publicizing and limited notification

Inadequate publicizing

• It is better to have notification in the mass media. I’m very dissatisfied with the level of notification. I think it is due to poor notifying that people are not sufficiently aware about diabetes.

• The diabetes unit does not pay much attention to holding festivals and sessions on diabetes. If these festivals are run, we will be encouraged to act on medical advice.

Lack of correct and timely notification to the community

• I was unaware of the disease and its dangers. I think there should be more efforts to inform the community. I was unaware of my diabetes till the stage of its progression.

• I didn’t know much about the disease until I was diagnosed and referred to the diabetes unit.

Inadequate equipment and facilities

Insufficient personal monitoring devices

• I do not have a blood glucose monitor, so I couldn’t measure my blood glucose levels or control my disease by medication.

• The diabetes unit did not cooperate with me to prepare the blood sugar device.

Limited access to related facilities

• I do not have access to sports facilities for managing my disease, which leads to non-adherence to medical advice.

• It takes one day for me to come to the health center and to have my blood glucose checked after a lot of waiting.

Poor inter-sectional coordination

Limited insurance coverage

• Foreign medications are not covered by insurance. I can’t afford to buy the prescribed medicines. If the government lets some medications be covered by insurance, the problems of providing medications will be solved and I’ll be able to control my disease.

• In my opinion, the government should provide patients more services, including releasing some foreign medications from customs warehousing, which can help diabetic patients to have access to their medicines.