The burden of chronic noncommunicable diseases in rural South Africa is exacerbated by delayed health-seeking. This study explored awareness, beliefs and health-seeking behaviour relating to diabetes, hypertension and cardiovascular diseases in Ingwavuma, a poor rural community in the uMkhanyakude district of KwaZulu-Natal, South Africa. Eight gender and age-stratified Focus Group Discussions (FGD) were conducted in isiZulu using a pre-tested FGD guide with seventy-six participants. Thematic analysis was done to discern views on access to care for noncommunicable diseases. Findings revealed limited awareness of hypertension, diabetes, and cardiovascular-related disease burden. The community practices medical plurality, and consultation with traditional healers precedes biomedical care for acute illness with symptoms like metabolic syndrome and cardiovascular diseases. Males prefer self-care and herbal remedies, probably due to cultural and masculinity expectations. Furthermore, distant health facilities and transport costs hinder biomedical care utilisation. Our study revealed the nuanced interaction of cultural and socioeconomic factors on chronic noncommunicable disease perception and health-seeking practices in Ingwavuma. The study indicates the need for improving access to primary healthcare facilities and community-based health promotion in partnership with community stakeholders to improve awareness and health-seeking behaviour.


cardiovascular diseases, diabetes, disease burden, health beliefs, health perceptions, hypertension, rural KwaZulu-Natal, medical plurality, noncommunicable diseases uMkhanyakude, South Africa, traditional and herbal medicine

Author Bio(s)

Herbert Chikafu is a doctoral candidate at the School of Nursing and Public Health - University of KwaZulu-Natal, South Africa. Herbert’s academic background is in Economics and Health Systems Studies. His areas of interest include community health, maternal health, health equity, policy evaluation, research methods, social determinants of health, and health economics. Please direct correspondence to chikafuh@gmail.com

Dr. Innocent Tinashe Mutero is a Postdoctoral fellow at the University of KwaZulu-Natal. He holds a master’s degree in Applied Ethnomusicology (UKZN), Ph.D. in Public Administration (DUT). His research interests focus on community engagement and social transformation through Social Practice Creative Placemaking. Please direct correspondence to muteroinnocent@gmail.com

Professor Moses Chimbari is a Public Health Research Professor in the School of Nursing and Public Health, University of KwaZulu-Natal (UKZN). Prof Chimbari is co-PI of the EMDIYA (Ethics for Mental health Digital Innovations for Youth in Africa) project, PI of EMDIYA-SA and member of the EMDIYA Management Committee. Please direct correspondence to Chimbari@ukzn.ac.za


Authors thank the Ingwavuma community for participating in this research. The researchers are also grateful to Dr. Hlengiwe Sacolo-Gwebu for reviewing the study tool and expertly moderating focus group discussions.

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