Abstract:
Noncommunicable diseases (NCD) have emerged as major causes of deaths in the
Philippines, posing a significant public health challenge. In particular, the country is
burdened with the increasing prevalence of hypertension (HTN) and diabetes mellitus (DM),
despite several governmental interventions to curb these lifestyle-related diseases.
Understanding the patients’ pathway, taking into account the factors contributing to their
engagement or disengagement, through the ‘continuum of care’ is crucial to the success of
HTN and DM management and control. As such, this social inquiry aims to explore the
facilitators (enablers) and barrier (disablers) influencing the progression of patients with
hypertension and diabetes at each stage of the continuum of care in a rural island province in
the Philippines.
Using a qualitative case study approach, the study conducted semi-structured
interviews with six people living with HTN and DM, and key informant interviews with three
barangay health workers and two health officials in Marinduque Province. Thematic analysis,
guided by the socio-ecological model for health promotion, revealed multiple compounding
enablers and disablers ranging from the intrapersonal, interpersonal, organizational,
community and policy levels at each stage of the care continuum. The findings emphasize the
need for holistic, multi-level interventions that address the complex and multidimensional
challenges and opportunities encountered by individuals along their care journey. By
adopting a holistic approach, the Philippine healthcare system and society as a whole can
better support chronically ill Filipinos in their journey towards improved engagement and
health outcomes.
