Patient pathways for diabetes and hypertension care in Bhiwandi

The study highlights the complex and often convoluted care-seeking journeys of individuals living with diabetes and hypertension in urban informal settlements of the Mumbai Metropolitan Region. Patients frequently encounter delays in diagnosis and treatment initiation, primarily due to their initial consultations with local physicians who may lack the necessary qualifications to effectively diagnose these non-communicable diseases (NCDs). This leads to a cycle of switching between various healthcare providers, including small local doctors, larger private practitioners, and public health facilities. The findings indicate that advice from family and friends significantly influences patients' choices, while financial constraints often dictate their ability to access appropriate care.

Moreover, the research underscores a critical gap in community awareness regarding the prevention and early diagnosis of NCDs. Many individuals do not perceive the need for screening unless they experience severe symptoms, which contributes to late diagnoses and poor health outcomes. The study calls for a more integrated approach to healthcare that includes reliable first-contact points for NCD care and emphasizes the importance of educating the community on prevention strategies. By addressing these challenges, health policies can be better aligned to meet the unique needs of vulnerable populations living in urban informal settlements, ultimately improving health equity and outcomes for those affected by chronic diseases.