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

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Multimorbidity, the presence of multiple chronic conditions, requires context-specific understanding in Africa. Research adapted the concept to center people living with multimorbidity (PLWMM) and their social contexts.

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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.