293 Mobility, food access and continuity of care for diabetes among forcibly displaced persons in Adjumani District, Uganda

Abstract OP 2: Determinants of Health Disease and Interventions 4, B210 (FCSH), September 3, 2025, 14:30 - 15:30 Background Forcibly displaced Persons (FDPs) have a high burden of non-communicable diseases (NCDs) such as diabetes. While a healthy diet is a core component in the control and management of diabetes, access to food is complicated in emergency settings. Few studies focus on the intersection between mobility and food access by FDPs with diabetes at various stages of forced displacement, particularly in the Global South. Aim This paper examines how mobility affects food access and continuity of care for Sudanese and South Sudanese FDPs with diabetes during flight, on arrival, and after settlement in the host country. Methods It draws on data from photovoice and in-depth interviews with 30 refugees and asylum seekers in Nyumanzi Reception Centre and Settlement, as well as 10 key informant interviews with stakeholders in Adjumani District, Northern Uganda. Data collection took a community based participatory approach involving refugees as peer researchers. Results We found that adherence to dietary recommendations is constrained by various challenges at different points. During transit, FDPs prioritize survival, not managing the illness. On arrival at the reception centre, adherence to dietary recommendations is difficult because FDPs have limited choice regarding the composition and timing of meals. In the settlement, FDPs suffer food insecurity due to reduced and/or discontinued food rations, insufficient land for cultivation, and poverty due to limited economic opportunities. Conclusion Forced displacement complicates adherence to dietary requirements for diabetic patients at different phases of their migration journey. Proper diabetes care requires continuing dietary adjustment; lack thereof increases the vulnerability of these FDPs. This calls for special considerations for FDPs living with diabetes if continuity of care is to be attained.