A new study, published in the BMJ on July 15, 2025, by researchers from Makerere University School of Public Health and partners, highlights how social norms drive behaviours that increase the risk of Type 2 diabetes in Uganda.
The study was authored by Juliet Kiguli, Joseph K. B. Matovu, Francis Xavier Kasujja, Joyce Nabaliisa, and Ramadhan Kirunda, with contributions from Gloria Naggayi, Junior Mike Wejuli, Tom Okade, Ninsiima Lesley Rose, Ali Halage, and Roy William Mayega.
The study, funded by the government of Uganda through Makerere’s Research and Innovations Fund (RIF), explored how dietary-related norms influence everyday decisions in two high-burden districts, Bugiri and Busia.
Using a qualitative approach grounded in the Social Norms Exploration Toolkit, the research engaged 45 participants, including individuals with diabetes, caregivers, health workers, and community influencers.
The findings reveal that while awareness of healthy eating exists, cultural expectations often override knowledge.
Norms such as “tea without sugar is mistreatment”and “fried food is a sign of a good wife” pressure women to cook unhealthy meals, fearing sanctions like stigma, domestic violence, or marital breakdown.
For men, consuming fatty and fried foods is tied to social status and respect, further entrenching harmful practices.
The authors recommend that diabetes prevention strategies go beyond individual awareness campaigns. They call for family-centred, gender-sensitive interventions that address cultural drivers and empower women.
Engaging cultural institutions, involving key influencers, and integrating social norms change into health promotion programmes are critical steps to reducing risk.
The study concludes that awareness alone is not enough, as people tend to follow socially enforced norms. The authors urge policymakers to adopt multi-sectoral strategies that address these cultural drivers for sustainable diabetes prevention.
📖 Read the full article: https://bmjopen.bmj.com/content/15/7/e099600.
