Self-Efficacy and Health Behavior Outcomes in Non-Communicable Diseases (NCDS): Examining Gendered Pathway

Self-Efficacy and Health Behavior Outcomes in Non-Communicable Diseases (NCDS): Examining Gendered Pathway

Hope Herbert Nkhoma^1*, Dr. Lawrence Janeit Harrison Chipao²

¹Lecturer and Head of Psychology, Malawi Assemblies of God University, Lilongwe, Malawi.

²Dean of Theology, Malawi Assemblies of God University, Lilongwe, Malawi

*Corresponding Author

DOI: https://dx.doi.org/10.47772/IJRISS.2025.90900083

Received: 20 August 2025; Accepted: 26 August 2025; Published: 30 September 2025

ABSTRACT

This research delves into how self-efficacy influences health behaviors in individuals dealing with non-communicable diseases (NCDs), paying special attention to the different experiences of men and women. By examining existing studies, policy papers, and global health reports, the study sheds light on the ways gender shapes the development and expression of self-efficacy in preventing and managing NCDs. The findings indicate that self-efficacy plays a vital role in encouraging positive health behaviors—like sticking to medication, maintaining a healthy diet, and staying active—but its effects are influenced by gender norms, resource availability, and psychological factors. Women often encounter systemic obstacles that undermine their sense of control over health choices, even though they tend to engage more in preventive care. Conversely, men may feel more confident in handling physical symptoms but are less inclined to seek emotional or social support. This research underscores the importance of creating health interventions that consider gender differences, aiming to boost self-efficacy and ensure fair outcomes in NCD care. By bringing together existing insights, this study enhanced our understanding of how gender dynamics affect health behaviors and suggests ways to develop more inclusive public health strategies.

Keywords: Self-efficacy, health behavior, health outcomes, gender norms, gender roles, masculinity and health

INTRODUCTION

Non-communicable diseases (NCDs) like heart disease, diabetes, cancer, and chronic respiratory issues have become some of the top causes of illness and death around the globe, hitting low- and middle-income countries the hardest. As the global health community shifts gears from just treating these conditions to focusing on prevention and long-term management, it’s becoming more important than ever to understand the psychosocial factors that shape health behaviors. One key factor is self-efficacy—essentially, how confident a person feels in their ability to take the necessary steps to manage their health. This belief plays a crucial role in effectively preventing and controlling diseases.

This research dives into existing literature to examine how self-efficacy impacts health behavior outcomes for individuals living with non-communicable diseases (NCDs), paying special attention to the different paths shaped by gender. Gender, being a social construct, plays a significant role in determining access to resources, health decision-making, and behavioral responses—factors that are often overlooked in traditional health models. Women might encounter specific challenges like caregiving responsibilities, limited independence, and less access to health information, while men may feel restricted by societal norms that discourage seeking help and showing emotional vulnerability. These gender dynamics not only influence the development of self-efficacy but also affect how it translates into real-world health behaviors.

By exploring these intersections, this study seeks to shed light on the complex ways gender influences the relationship between self-efficacy and health outcomes in the realm of NCDs. The insights gained will help shape more inclusive, equitable, and effective public health interventions that acknowledge and address the varied needs of both men and women in managing chronic illnesses.

BACKGROUND

Non-communicable diseases (NCDs) like cardiovascular diseases, diabetes, cancer, and chronic respiratory conditions account for about 74% of deaths worldwide each year, with low- and middle-income countries bearing the brunt of this burden (WHO, 2023). The good news is that many of these diseases can be prevented through changes in lifestyle, but getting people to change their habits continues to be a tough nut to crack in public health.

One key psychological factor that plays a big role in encouraging health behavior change is self-efficacy. This concept, introduced by Bandura, refers to a person’s belief in their ability to carry out the actions needed to achieve specific results (Bandura, 1997). Research shows that higher self-efficacy is consistently associated with better health-promoting behaviors, such as staying active, eating well, and sticking to medication regimens among those with NCDs. For example, a systematic review by Sari et al. (2023) highlighted that self-efficacy is a strong predictor of lifestyle changes in various NCDs, including hypertension, diabetes, and chronic obstructive pulmonary disease.

The connection between self-efficacy and health outcomes isn’t the same for everyone. Gender significantly influences how self-efficacy and health behaviors develop. For instance, women often encounter various structural and psychosocial hurdles—like caregiving duties, limited independence, and less access to health information—that can weaken their self-efficacy, even though they tend to engage more in preventive care (Mphasha et al., 2023). On the other hand, men might feel more confident when it comes to handling physical symptoms, but they’re less inclined to seek out emotional or social support, largely due to cultural expectations that discourage showing vulnerability (Alberga et al., 2022).

Even with global pledges to adopt gender-responsive health strategies, many national non-communicable diseases (NCD) plans still overlook gender issues or only address them on a surface level. A recent review of 65 integrated NCD plans from 89 countries found that just 17% were truly gender-responsive, and only 2% took a gender-transformative approach (George Institute, 2023). This highlights a pressing need to weave gender-sensitive frameworks into the policies for preventing and managing NCDs.

This research pulls together existing literature and policy analyses to shed light on how self-efficacy affects health behaviors differently for different genders in the context of non-communicable diseases (NCDs). Grasping these dynamics is crucial for creating inclusive interventions that ensure fair health outcomes for everyone, regardless of gender.

Problem Statement

Non-communicable diseases (NCDs) are responsible for a staggering number of deaths worldwide, hitting low- and middle-income countries particularly hard. Even though there’s been a rise in awareness and funding for prevention and management, the health outcomes for those living with NCDs often fall short of what we’d hope for. A key factor that hasn’t received enough attention is self-efficacy—essentially, it’s about believing in one’s ability to manage health-related actions. Research shows that self-efficacy can greatly influence behaviors like sticking to medication, staying active, and making healthy food choices, but its impact varies across different groups.

Gender is a crucial element in shaping self-efficacy and health behaviors, yet many public health initiatives overlook the complex social differences between men and women. Women often encounter systemic obstacles, such as limited healthcare access, less decision-making power, and heavier caregiving responsibilities, which can chip away at their self-efficacy. On the flip side, men might be swayed by cultural expectations that discourage them from showing vulnerability or seeking help, which can hinder their participation in preventive care. Unfortunately, these gender-specific issues are seldom addressed in current NCD strategies, leading to interventions that miss the mark when it comes to meeting the diverse needs of various populations.

This research aimed to fill a crucial gap by exploring how gender impacts the connection between self-efficacy and health behavior outcomes, particularly in the realm of non-communicable diseases (NCDs). By bringing together existing studies and policy insights, the goal was to guide the creation of more inclusive and gender-sensitive strategies that enhance chronic disease management and foster fair health outcomes for everyone.

General Objective

To explore the influence of self-efficacy on health behavior outcomes in individuals living with non-communicable diseases (NCDs), with a particular focus on how gendered pathways shape these relationships.

Specific Objectives

1. To review existing literature on the role of self-efficacy in the prevention and management of NCDs.
2. To examine gender-based differences in self-efficacy levels and their impact on health behaviors among individuals with NCDs.
3. To analyze policy and programmatic approaches that incorporate gender-sensitive strategies to enhance self-efficacy in NCD care.

METHODOLOGY

The study took a closer look at how we gather and analyze existing secondary data to understand the link between self-efficacy and health behaviors, particularly in the realm of non-communicable diseases (NCDs), while paying special attention to how gender influences these pathways.

Research Design

The research was qualitative and exploratory in nature. It aimed to generate insights by analyzing existing literature, policy documents, global health reports, and peer-reviewed studies related to self-efficacy, gender, and NCD management.

Data Sources

The study drew on a wide range of credible secondary sources, including:

• Peer-reviewed journal articles from databases such as PubMed, Scopus, and Google Scholar
• Reports from international organizations (e.g., WHO, UN Women, The George Institute)
• National and regional NCD policy frameworks
• Systematic reviews and meta-analyses on self-efficacy and gender in health behavior

Data Collection Procedure

Relevant literature was identified using targeted keyword searches such as:

• Self-efficacy AND non-communicable diseases
• Gender differences in health behavior
• NCD prevention AND psychosocial factors
• Gender-responsive health interventions

Inclusion criteria:

• Studies focused on adult populations
• Research addressing gender-specific outcomes or interventions

Exclusion criteria:

• Studies focused solely on communicable diseases
• Articles lacking empirical or policy relevance

Data Analysis

The collected data was analyzed thematically to identify:

• Patterns in how self-efficacy influences health behaviors across genders
• Structural and cultural factors mediating gendered health outcomes
• Gaps in current policy and intervention frameworks

Themes were organized under key domains such as:

• Psychological determinants of health behavior
• Gender norms and roles
• Access to health resources
• Policy responsiveness to gender and self-efficacy

Ethical Considerations

As a study relying solely on publicly available data, no ethical approval was required. However, all sources were cited appropriately to maintain academic integrity and respect intellectual property.

LITERATURE SEARCH

Self-efficacy, a concept introduced by Bandura (1997), refers to the belief in one’s own ability to carry out the actions needed to achieve specific goals. This belief has become a key factor in managing non-communicable diseases (NCDs). It not only affects how people adopt health-promoting habits but also plays a crucial role in their ability to stick with those habits, especially when faced with challenges, which is vital for managing chronic diseases effectively.

Self-Efficacy and Health Behavior in NCDs A wealth of research has shown that people who believe in their own abilities, or have higher self-efficacy, are more inclined to adopt preventive habits like staying active, eating well, and sticking to their medication routines (Schwarzer & Luszczynska, 2008). Take the Health Action Process Approach (HAPA) model, for example; it highlights self-efficacy as a key player that bridges the gap between intention and action, particularly when it comes to lifestyle-related non-communicable diseases (NCDs) such as diabetes and heart disease.

Luszczynska and Schwarzer (2005) also point out that self-efficacy is not just about kicking off new behaviors but also about keeping them up, which is vital for managing diseases over the long haul. This idea is supported by Buchanan and Miller’s (2006) ethical analysis, which stresses the need to empower individuals through behavioral strategies that boost self-efficacy, rather than just depending on outside motivators.

Gendered Pathways in Self-Efficacy and Health Outcomes Gender plays a crucial role in shaping our beliefs about self-efficacy and our health behaviors. Women often encounter various structural and cultural obstacles that can shake their confidence in managing their health. These challenges include limited access to resources, the weight of caregiving responsibilities, and societal expectations (WHO, 2019). According to the George Institute (2021), men are hit harder by non-communicable diseases (NCDs) but are still underrepresented in clinical research and policy-making.

On the flip side, Courtenay (2000) discusses how traditional views of masculinity can prevent men from seeking help or taking part in preventive care, which often results in worse health outcomes. These gender norms shape how self-efficacy is demonstrated and acted upon, indicating that any interventions need to be specifically designed to tackle these psychosocial factors.

Integrating Gender into Self-Efficacy-Based Interventions

To enhance outcomes for non-communicable diseases (NCDs), health programs need to embrace gender-responsive strategies that boost self-efficacy among various populations. This means crafting interventions that take into account the unique motivators, obstacles, and social contexts tied to gender. As Bandura (1997) pointed out, the best way to build self-efficacy is through mastery experiences—so, programs should create chances for both men and women to succeed in managing their health.

Additionally, policy frameworks should go beyond just being gender-neutral and actively include gender analysis to guarantee fair health outcomes (WHO, 2019). This approach not only empowers individuals but also fortifies public health systems.

Data Extraction Matrix and Analysis

Findings from each source

FINDINGS

Based on the synthesis of existing literature, policy documents, and global health reports, the following key findings emerged:

1. Self-Efficacy Strongly Influences Health Behavior in NCDs

• Individuals with higher self-efficacy are more likely to engage in health-promoting behaviors such as regular exercise, dietary control, and medication adherence.
• Self-efficacy enhances resilience in managing chronic conditions and improves long-term health outcomes (Bandura, 1997; Schwarzer & Luszczynska, 2008).

2. Gender Significantly Shapes Self-Efficacy Pathways

• Men often report lower self-efficacy due to structural and cultural barriers such as societal expectations to appear self-reliant, reluctance to seek help for emotional or preventive care, and stigmatization of vulnerability in health contexts (Courtenay, 2000; WHO, 2019).
• Men experience reduced confidence in managing their overall well-being, yet often avoid seeking emotional support or preventive services due to cultural pressures to maintain stoicism and self-reliance (Courtenay, 2000).

3. Health Systems and Policies Often Lack Gender Responsiveness

• Most national NCD strategies are gender-neutral, failing to address the distinct needs and experiences of men and women.
• Only a small fraction of global NCD action plans incorporate gender-transformative approaches (George Institute, 2021).

4. Interventions That Enhance Self-Efficacy Are More Effective When Gender-Sensitive

• Programs that tailor strategies to gender-specific motivators and barriers show greater success in promoting behavior change.
• Empowerment-based models that build mastery experiences and social support are particularly effective across genders (Luszczynska & Schwarzer, 2005)

CONCLUSIONS

This research underscores the critical role of self-efficacy in shaping health behavior outcomes among individuals living with NCDs. While self-efficacy is a well-established predictor of positive health behaviors, its development and expression are deeply influenced by gendered social norms, roles, and access to resources.

Women often face systemic challenges that undermine their confidence in managing health, despite being more engaged in preventive care. Men, on the other hand, struggle with emotional and social aspects of health due to restrictive gender norms. These disparities highlight the urgent need for gender-sensitive interventions that not only enhance self-efficacy but also address the broader social determinants of health.

To truly enhance health outcomes for non-communicable diseases (NCDs) in a fair way, public health strategies need to go beyond just gender-neutral approaches. We should embrace inclusive and transformative methods that empower everyone, regardless of where they fall on the gender spectrum. By boosting self-efficacy through programs that are culturally and contextually relevant, we can foster lasting behavior changes and ultimately improve health for everyone.

REFERENCE

1. Alberga, A. S., et al. (2022). The mediating role of self-efficacy in the relationship between premotivational cognitions and engagement in multiple health behaviors. Journal of Multidisciplinary Healthcare, 15, 1455–1467. https://doi.org/10.2147/JMDH.S359981.
2. Bandura, A. (1997). Self-efficacy: The exercise of control. New York: W.H. Freeman.
3. Buchanan, D. R., & Miller, F. G. (2006). A public health ethics perspective on the goals of behavioral health promotion programs. Health Education & Behavior, 33(3), 341–351.
4. Courtenay, W. H. (2000). Constructions of masculinity and their influence on men’s well-being: A theory of gender and health. Social Science & Medicine, 50(10), 1385–1401.
5. Sari, N. P., et al. (2023). The role of self-efficacy towards health-promoting lifestyle among patients with non-communicable disease. medRxiv. https://doi.org/10.1101/2025.01.05.25320027.
6. Schwarzer, R., & Luszczynska, A. (2008). How to overcome health-compromising behaviors: The health action process approach. European Psychologist, 13(2), 141–151.
7. Luszczynska, A., & Schwarzer, R. (2005). Social cognitive theory and health behavior. In M. Conner & P. Norman (Eds.), Predicting Health Behaviour (2nd ed.). Open University Press.
8. Mphasha, M., et al. (2023). An evaluation of community health workers’ knowledge, attitude and personal lifestyle behaviour in NCD health promotion. International Journal of Environmental Research and Public Health, 20(9), 5642. https://doi.org/10.3390/ijerph20095642
9. The George Institute for Global Health. (2023). Analysis of how gender features in NCD action plans. Retrieved from https://www.georgeinstitute.org
10. World Health Organization (WHO). (2023). Non-communicable diseases. Retrieved from https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases