Management of comorbidity, the case of hypertension and type-2 diabetes among women in Ghana: a qualitative study

Background The coexistence of hypertension (HTN) and type 2 diabetes (T2D) poses a growing public health challenge in Ghana, where chronic care remains fragmented and single-disease focused. Women living with both conditions face sustained self-management demands that extend beyond clinical treatment. This study explored the lived experiences of women managing comorbid HTN and T2D in Ghana. Methods An exploratory qualitative study was conducted across four district hospitals in Ghana. 59 women aged ≥ 30 years with a confirmed diagnosis of both HTN and T2D for at least six months were purposively recruited. Data were collected between September and October 2024 using in-depth interviews guided by the WHO Package of Essential Non-Communicable Disease Interventions (WHO-PEN) framework. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed using Atlas. ti, with independent coding to enhance analytical rigor Results Themes that emerged from this study include: psychological distress, treatment burden, economic burden, and physical challenges. Participants reported fear, sadness, confusion, frustration, and loneliness following diagnosis. Treatment burden included lifelong medication use, dietary restrictions, and difficulty sustaining physical activity. Economic challenges involved out-of-pocket medication payments, transport costs, and reduced work productivity. Physical effects such as fatigue, weakness, pain, sleep disturbances, frequent urination, weight loss, and reduced sexual drive. Conclusion Women managing comorbid HTN and T2D in Ghana experience multidimensional challenges within a fragmented care system. Therefore, Integrated, patient-centered chronic disease management with strengthened financial and psychosocial support is essential to improve long-term outcomes.