Navigating NCDs’ Self-Management: A Comprehensive Review of Barriers & Facilitators in LMICs through Quantitative and Qualitative Lenses

Abstract

Introduction: Despite significant global and national investments in health, primarily aimed at primary and preventive measures, progress in alleviating toll of non-communicable diseases (NCDs) remains sluggish in low-and middle-income countries, hindering the achievement of Sustainable Development Goals by 2030. This review intends to elucidate the barriers and facilitators affecting self-management of NCDs and their determinants, with purpose of informing the development of more accessible and practical preventive strategies. Methods: An extensive electronic literature search was conducted across PubMed, PsycINFO, CINAHL, and Scopus for studies published between 2013 to June 2024, resulting in total of 78 included studies: 56 quantitative, 20 qualitative, and 2 mixed-methods. Findings: The synthesis of findings across these studies identified critical factors influencing NCDs’ selfmanagement. The quantitative analysis highlighted 31 factors grouped into five main determinants: sociodemographic, psychosocial, behavioural, biological, resource-related, and health-system-related. Notably, increased age and educational attainment correlated positively with self-management compliance, while barriers such as forgetfulness and misconceptions negatively impacted adherence. The qualitative review identified 21 sub-themes under five broad themes, emphasizing personal challenges, financial limitations, environmental factors, social stigma, and issues with health providers. Conclusion: Together, these insights reveal the multifaceted challenges of self-management and necessity for tailored interventions.