The Patients’ Journey to NCD Management: Enablers and Disablers on the Engagement in the Hypertension and Diabetes Mellitus Continuum of Care in Marinduque, Philippines

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.