Knowledge, attitudes and care-seeking behaviours related to chronic disease management among migrant workers in Singapore: a cross-sectional study

Chronic diseases such as hypertension, hyperlipidaemia, and diabetes (3Hs) are major global health concerns. Low-wage migrant workers are at higher risk of developing 3Hs due to sociocultural, economic, and lifestyle factors. Yet, research on the management of these chronic conditions within this population remains limited. This study aimed to assess knowledge, attitudes, and care-seeking behaviours related to chronic disease management among low-wage male migrant workers in Singapore with self-reported hypertension, hyperlipidaemia and diabetes. A cross-sectional survey was conducted at a large migrant worker clinic from September to November 2024. The survey assessed knowledge of 3 H symptoms, risk factors and management, attitudes to medication adherence and regular follow-up appointments, and care-seeking. Descriptive and logistic regression analyses were performed. Among 356 participants, 92.4% were from Bangladesh or India, and more than two-thirds had at least two chronic diseases. While 62.4% demonstrated good 3Hs knowledge of the risk factors, symptoms, and complications, specific gaps remained particularly in recognising symptoms and understanding the risks of high salt intake. More than half expressed positive attitudes toward medication adherence. However, 19.7% were not taking their prescribed medications at all and 52% reported no lifestyle changes after diagnosis. Of those who attended follow-up within one month ( n = 281), 49.5% cited employer reminders as a reason. The absence of physical symptoms was the most common reason for delayed follow-ups. An increased number of chronic conditions (Multiple 3Hs) was significantly associated with higher knowledge (OR = 1.85, 95% CI 1.14–3.06, p = 0.01) and attitude scores (OR = 1.95, 95% CI 1.21–3.18, p = 0.01), but not with improved care-seeking behaviour scores. We identified key knowledge gaps including misunderstanding about the asymptomatic nature of 3Hs and limited awareness of dietary risks. Employer involvement emerged as a key enabler of timely healthcare access. Although workers generally held positive attitudes towards medication adherence and regular follow-ups, these did not consistently translate into care-seeking. Future efforts should prioritise culturally tailored health education alongside sustained employer engagement to support equitable chronic disease management.