Cultural perceptions and care practices for hypertension and diabetes: a qualitative study among the bajo coastal community in Indonesia.

Abstract

BackgroundHypertension and diabetes are increasing in Indonesian coastal communities, where limited healthcare access and strong socio-cultural influences shape illness perceptions, care-seeking, and chronic disease management.ObjectiveThis study aimed to explore how the Bajo coastal community perceives and responds to hypertension and diabetes within their social and cultural context.MethodsA descriptive qualitative design was employed. Fourteen adults diagnosed with hypertension and/or diabetes in a coastal district of Southeast Sulawesi, Indonesia, were purposively selected. Data were collected through semi-structured, in-depth interviews and analyzed thematically using Braun and Clarke's approach.ResultsFour themes emerged: (1) perceptions of chronic disease, including symptoms, causes, and risks; (2) cultural beliefs and traditional healing practices; (3) self-awareness and health behaviors in the context of limited healthcare access; and (4) social roles and environment, particularly the influence of family, customary leaders, and community-based health education. Participants commonly understood illness through bodily symptoms, informal knowledge, and spiritual meanings. Care pathways were often pluralistic, combining traditional and biomedical treatment, while access to diagnosis and continuity of care was constrained by distance, cost, and limited services.ConclusionChronic disease care in the Bajo community is shaped by cultural beliefs, social relationships, and structural barriers. Culturally responsive, community-based, and equity-oriented strategies are needed to improve care in remote coastal settings.