Abstract:
Cardiovascular diseases (CVDs) persist as a primary cause of morbidity and mortality globally, exerting a particularly significant influence on resource-constrained and geographically remote areas like Gilgit-Baltistan. Despite the escalating prevalence of CVDs within Pakistan, diagnostic delays are still prevalent, leading to advanced disease stages, preventable complications, and enduring disabilities. This research sought to investigate the role of limited health literacy, cultural interpretations of symptoms, and the use of traditional treatments in the delayed diagnosis and management of cardiovascular ailments within the Gilgit-Baltistan populace. The central aims were to assess community perceptions of CVD symptoms, pinpoint the cultural and behavioral factors shaping treatment decisions, and elucidate the determinants of delayed health-seeking behaviors. The qualitative investigation employed in-depth, semi-structured interviews, with all findings analyzed retrospectively. A total of 22 interviews were undertaken, and participants were purposively chosen from random community interactions. Some participants were hospital patients, while others were individuals visited in their residences, selected based on the presence of reported cardiovascular symptoms and their expressed willingness to participate. The investigation revealed a robust correlation between restricted functional health literacy and the misinterpretation of initial symptoms, which were frequently ascribed to stress, exhaustion, or gastrointestinal problems. These misunderstandings often prompted individuals to initially seek relief through herbal remedies, indigenous treatments, and spiritual practices, a behavior molded by cultural conventions and further exacerbated by economic and locational limitations. Furthermore, structural impediments, including considerable travel distances, transportation challenges, and insufficient financial means, significantly delayed access to biomedical care, frequently prolonging the interval before clinical consultation by several months and adversely impacting health outcomes. According to the outcome of the research, the late diagnosis of cardiovascular disease (CVD) in Gilgit-Baltistan is a result of the complex interrelationship between the cultural standards and practices, the limited health literacy levels, and the substantial infrastructural challenges. Such findings show that special emphasis must be placed on the importance of culturally relevant health education programs, community-based resource mobilization of awareness, and involvement of more diagnostic institutions. Therefore, improved primary healthcare systems and inclusion of culturally sensitivecommunication strategies may help make these marginalized mountainous groups detect CVD earlier, treat it promptly, and reduce the burden of this disease.
