Faith-Based Health Cadres in Indonesia: Perceptions, Challenges, and Community Strategies for Non-Communicable Disease Prevention

Vollständiger Abstract

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Introduction: The rising incidence of non-communicable diseases (NCDs) imposes considerable multidimensional burdens. Objective: To assess the perspectives of faith-based health cadres (FBHCs) regarding their roles and competencies and explore the barriers and strategies related to NCD prevention and management at the community level. Materials and Methods: A sequential explanatory mixed-method design was employed with 41 cadres from an Islamic women organization (Kulonprogo Branch of ‘Aisyiyah, Indonesia). Quantitative data were collected using the validated COCS-N questionnaire and analyzed with non-parametric statistics, followed by qualitative exploration using open-ended questions and thematic analysis. Results: FBHCs reported generally positive perceptions of their roles and competencies. Statistical analysis showed no significant differences by age, education, occupation, or training history, although longer service as health cadres was significantly associated with stronger role perception (r = 0.350, p = 0.025). Four qualitative themes emerged: (1) community barriers to implementing healthy lifestyles, (2) challenges in public education on NCD prevention and care, (3) potential community-based strategies for the prevention of NCDs, and (4) faith-based multifaceted roles in promoting community health framed within dakwah (Islamic outreach/proselytizing activities). Barriers included low awareness, stigma, cultural practices, and socioeconomic constraints, while strategies emphasized tailored education, male involvement, community engagement, and multisectoral collaboration. Conclusions: FBHCs are uniquely positioned to strengthen formal health systems by combining health promotion with religious motivation, which fosters resilience and community acceptance. Strengthening and integrating their capacity into national programs could enhance NCD prevention in Indonesia and offer lessons for other faith-oriented, low-resource settings.