Digital and Integrated Reproductive Health Support for Diabetes Management among Women of Childbearing Age in Chipata, Eastern Province, Zambia: A Cross-Sectional Study

Abstract

Diabetes mellitus among women of childbearing age is a growing public health concern that requires integrated clinical, reproductive, and technological interventions. In many low-resource settings, diabetes care and reproductive health services remain fragmented, limiting access to comprehensive support for glucose monitoring, medication adherence, pregnancy planning, contraception counselling, and healthy lifestyle practices. This study assessed the role of digital and integrated reproductive health support in diabetes management among women of childbearing age in Chipata District, Eastern Province, Zambia. A quantitative cross-sectional study was conducted among 100 women aged 18–49 years with diagnosed diabetes attending selected health facilities. Data were collected using structured questionnaires covering socio-demographic characteristics, diabetes self-management, reproductive health support, access to digital health technologies, and perceptions of integrated healthcare services. Descriptive statistics and Chi-square tests were performed using SPSS version 26. The findings showed that 82% of participants owned mobile phones, 65% had access to internet-enabled devices, and 85% expressed willingness to use digital platforms for diabetes education and reproductive health support. However, only 42% reported receiving integrated reproductive health counselling during diabetes clinic visits. Digital health utilization was significantly associated with improved diabetes self-management practices (?² = 8.47, p = 0.014). The study concludes that digital health interventions and integrated reproductive healthcare can enhance diabetes self-management among women of childbearing age. Strengthening digital literacy, expanding mobile health interventions, and integrating reproductive health services into diabetes care are recommended to improve health outcomes in Zambia and similar resource-constrained settings.

Introduction

Diabetes mellitus is one of the fastest-growing non-communicable diseases globally, with a rapidly increasing burden in low- and middle-income countries, including Zambia. Women of reproductive age with diabetes face unique challenges because the disease affects not only blood glucose control but also menstruation, fertility, contraception, pregnancy, and maternal health. Poorly managed diabetes increases the risk of miscarriage, congenital abnormalities, maternal complications, and adverse neonatal outcomes. Despite these risks, reproductive health services are often not integrated into diabetes care, leaving many women without adequate counselling and support.

Integrated healthcare models that combine diabetes management with reproductive health services are recommended to improve continuity of care, patient education, pregnancy planning, and overall quality of life. In Zambia, however, women with diabetes continue to experience barriers such as limited healthcare access, inadequate reproductive health information, socioeconomic challenges, and shortages of specialist services, especially in rural and peri-urban areas.

Digital health technologies—including mobile health (mHealth) applications, SMS reminders, telemedicine, electronic health records, and virtual consultations—offer opportunities to improve diabetes self-management by supporting medication adherence, healthy lifestyles, patient education, and communication with healthcare providers. They can also enhance reproductive health by providing information on contraception, pregnancy planning, nutrition, and medication safety. However, challenges such as digital literacy, internet connectivity, affordability, privacy concerns, and healthcare worker preparedness must be addressed.

The study focuses on Chipata District, Eastern Province, Zambia, where limited research has examined the integration of digital health and reproductive healthcare for women with diabetes. It aims to assess access to digital health technologies, evaluate reproductive health support, examine the relationship between digital health use and diabetes self-management, and identify barriers to integrated care.

The study is guided by Dorothea Orem’s Self-Care Theory, which emphasizes that individuals can effectively manage their health when provided with adequate knowledge, resources, and support. Digital health and integrated reproductive counselling are viewed as tools that strengthen women's self-care abilities, enabling better medication adherence, blood glucose monitoring, clinic attendance, healthy lifestyles, and informed reproductive health decisions.

The literature shows that digital health interventions improve diabetes management and reproductive healthcare separately, but there is limited evidence on their combined use, particularly in Zambia. This study addresses this gap by investigating how integrated digital reproductive health support can improve diabetes self-management among women of childbearing age in a low-resource setting.

Conclusion

The study concludes that digital and integrated reproductive health support represents an important strategy for improving diabetes management among women of childbearing age in Chipata District. Although mobile phone access was high, integration of reproductive health services into diabetes care remains inadequate. Digital health interventions can improve self-management practices by providing continuous education, reminders, and healthcare communication. Strengthening digital healthcare infrastructure, training healthcare providers, and integrating reproductive health services into diabetes clinics are essential for improving outcomes among women living with diabetes.

References

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Copyright

Copyright © 2026 Y. Mary Stella Bai, Dr. K. Emmanuel, Dr. Rightwell K. Gondwe, Aleyamma James. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.