Bridging inequities in self-care for hypertension and type 2 diabetes in rural areas: the role of social determinants and social capital

Non-communicable diseases (NCDs) have a major role in the persistence of health inequalities globally. Although some high-income countries have made progress in the prevention and management of NCDs, low- and middle-income countries (LMICs) still continue to face significant challenges in reducing NCD-related mortality and providing equitable access to healthcare services. Notably, 86% of premature deaths from NCDs occur in LMICs, where barriers to prevention, diagnosis and treatment are exacerbated by socioeconomic disparities and geographical isolation.

In rural areas, where healthcare infrastructure is often weaker, and social and economic disadvantages are more pronounced, the burden of managing chronic conditions, such as hypertension and type 2 diabetes falls heavily on individuals. Self-care practices, including medical adherence, dietary changes and physical activity are important to managing these conditions. However, these practices are deeply influenced by social determinants of health, such as income, education, and access to healthcare, as well as social capital – the networks and relationships that shape individuals’ capacity to seek help, access information and make healthier choices.

This session will share insights from studies conducted in rural settings of LMICs, including Nepal and Kenya, contributing to the ongoing discourse on health equity by highlighting how social determinants and social capital shape self-care practices for hypertension and type 2 diabetes. The session will also discuss potential community-based and policy-driven solutions to improve equitable access to NCD care and empower individuals’ capacity for effective self-care.