Interdisciplinary perspectives on multimorbidity in Africa: Developing an expanded conceptual model

Area of Science:

• Global Health
• Health Systems Research
• Social Determinants of Health

Background:

• Multimorbidity, defined as co-occurring chronic conditions, presents a global health systems challenge.
• The concept's utility and definition in low- and middle-income settings, particularly Africa, remain debated.
• Existing definitions may not adequately capture the complexities of living with multiple conditions in diverse African contexts.

Purpose of the Study:

• To assess the utility of the multimorbidity concept within African health systems.
• To explore adaptations of the multimorbidity concept for African contexts.
• To develop a context-sensitive description of multimorbidity relevant to Africa.

Main Methods:

• An interdisciplinary research initiative involving 60 partners across 10 African countries.
• A three-day concept-building workshop utilizing grounded theory principles.
• Thematic coding of workshop discussions and iterative refinement of conceptual models.

Main Results:

• Three key themes emerged: focus on diseases, centering the needs of people living with multimorbidity (PLWMM), and stakeholder conceptual priorities.
• An expanded conceptual model was developed.
• The model highlights the catastrophic impacts of multimorbidity on individuals, families, service providers, and health systems.

Conclusions:

• The concept of multimorbidity needs adaptation to be useful and transformative in African settings.
• Revised concepts should prioritize the experiences and social contexts of PLWMM.
• A context-sensitive approach is crucial for addressing multimorbidity challenges in Africa.