“If I Were to Suffer a Stroke Right Now, the First Place That I Should Be Taken to Is the Traditional Healer”: Community Beliefs and Health-Seeking Practices for Noncommunicable Diseases in Rural KwaZulu-Natal, South Africa

Abstract

The burden of chronic noncommunicable diseases in rural South Africa is exacerbated by delayed health care seeking resulting in poor access to health care. 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.