A Qualitative Exploration of Facilitators and Barriers to Control of Hypertension and Type 2 Diabetes Mellitus in Rural Nagpur, Central India

Abstract Background: Hypertension (HTN) and type 2 diabetes mellitus (T2DM) are increasingly prevalent in rural India, yet disease control remains suboptimal due to a confluence of socio-cultural, behavioral, and systemic challenges. Understanding community-perceived facilitators and barriers is essential for improving chronic disease management in these settings. Materials and Methods: An exploratory qualitative study was conducted in the catchment area of the Primary Health Centre (PHC) Bela, Nagpur district, Maharashtra. Free listing and pile sorting exercises were conducted with 30 purposively selected participants, including controlled/uncontrolled patients and healthcare providers. Items mentioned were analyzed using Smith’s Salience Index (cut-off ≥ 0.1), followed by two-dimensional scaling and hierarchical clustering to identify thematic groupings, which were then applied to organize findings within capability-opportunity-motivation-behavior (COM-B) domains.