The 5-C model of digital health accompaniment: empowering women through a gestational diabetes self-care intervention in Vietnam

Background Globally, gestational diabetes mellitus (GDM) is a growing health problem. When diagnosed with GDM, women often lack adequate health systems and social support, finding themselves alone at the frontier of epidemiological change. This ethnographic study investigated experiences of GDM and self-care practices among women in Vietnam, with a particular focus on the significance of an online intervention for women’s self-care agency. Methods Ethnographic data from in-depth interviews with 42 women with GDM living in the Red River delta of northern Vietnam were analyzed. The research was conducted in two phases. In the first phase, women with GDM received standard care, while women in the second phase participated in a digital pregnancy care intervention combining peer- and professional support. Ethnographic data from both phases were systematically coded, analyzed, and compared. Results The study found that the intervention achieved its impact through accompaniment, supporting GDM self-care through presence and human connection. While women receiving standard care often found themselves in a stressful impasse between Internet-derived information emphasizing the dangers of GDM and family members urging them to ignore the condition, women involved in the digital intervention mobilized knowledge and support attained through the intervention to actively seek assistance from family members and carve out spaces for self-care. Women used the intervention to leverage family love. To capture the factors that made this intervention a source of accompaniment, we developed the 5-C model of digital health accompaniment, highlighting how co-creation, combined knowledge, community spirit, continued presence, and commitment over time facilitated health care accompaniment. Conclusions For many women worldwide, pregnancy is an emotionally intense period marked by high stakes and anxious expectations. When GDM is diagnosed, uncertainties tend to intensify. In this context, our findings suggest that digital interventions can serve not merely as tools for health education or monitoring, but as infrastructures of accompaniment that strengthen women’s self-care, while also enabling them to mobilize family members’ attention and support. We argue that such accompaniment represents an important source of reproductive empowerment that warrants greater attention in research, policy, and practice, holding potential to contribute to health system strengthening. Clinical trial registration https: //anthropology. ku. dk/research/research-projects/current-projects/ₗiving-together-with-chronic-disease-part-ii/, identifier NCT05744856.