The feasibility of promoting recreational physical activity to manage type 2 diabetes in urban Bangladesh: A qualitative study

Urbanisation has contributed to increased sedentary behaviour, which is a major risk factor for non-communicable diseases. In South Asia, the type 2 diabetes burden is rapidly increasing, and there is a need to understand the effect of different social categories, such as gender, socio-economic status, and diabetes status, in shaping opportunities to participate in physical activity. We used a rapid participatory qualitative research methodology and intersectional analysis in urban Faridpur, Bangladesh, to analyse the feasibility of promoting recreational physical activity to manage and prevent type 2 diabetes. Diabetes was defined as an individual as opposed to a community health issue in Faridpur. Narratives about the causes of diabetes blamed the individual, which prevented the development of a positive diabetes identity and resulted in intersectional stigma. Women, and poorer women in particular, felt disempowered by their diabetes and therefore hid this from others. There was a collective lack of awareness about community barriers to physical activity for women, and a need to create a safe and empowering space for women, while working at the community level to address these barriers. Cross-sectoral complex, community-engaged interventions that consider intersectional experiences are needed to increase physical activity in urban areas of South Asia.