Improving diabetes treatment outcomes: an agent-based model of patients’ self-management behaviours and treatment outcomes in Ghana

Despite Ghana's national health insurance coverage for diabetes (DM) care, many patients struggle to achieve adequate blood glucose control due to challenges with medication access, affordability, and adherence. This study explores type 2 diabetes patients’ self-management behaviour and how it influences blood glucose control, medicine adherence and admissions within Ghana’s public health system. The study uses health behaviour theories, clinicians’ expertise, and evidence from published literature to build an agent-based model for improving understanding and examining the benefits of selected public health interventions: a 20% sugar-sweetened beverage (SSB) tax, increasing medicine availability and insurance coverage. Experiment results indicate that a 10% increase in insurance coverage for five consecutive years is more effective at improving blood glucose, reducing admissions and increasing medicine adherence than implementing a 20% SSB tax or a 10% increase in medicine availability. The results have implication for national insurance operation and diabetes service planning and delivery.