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Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model
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Multimorbidity: a core priority for learning health systems amidst vertical disease programme cuts.

Justin Dixon1,2,3, Efison Dhodho4,5,6, Karen Webb7

  • 1The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe. justin.dixon@lshtm.ac.uk.

Health Research Policy and Systems
|February 20, 2026
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Summary

Learning health systems (LHS) offer a framework to address multimorbidity, integrating care and promoting self-reliance. An initiative in Zimbabwe demonstrates how reengineered electronic health records, deliberative platforms, and learning sites can build essential in-house capabilities for complex health needs.

Keywords:
Global healthLearning health systemsMultimorbidityZimbabwe

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Area of Science:

  • Health Systems Research
  • Public Health
  • Health Informatics

Background:

  • Global health systems face complex challenges, with multimorbidity being a significant cross-cutting issue.
  • Recent funding shifts necessitate more integrated, adaptive, and self-reliant health systems.
  • Multimorbidity requires a paradigm shift from vertical disease programs to integrated approaches.

Purpose of the Study:

  • To propose Learning Health Systems (LHS) as a framework for addressing multimorbidity.
  • To operationalize LHS principles with multimorbidity as a core priority.
  • To illustrate the application of LHS through an interdisciplinary initiative in Zimbabwe.

Main Methods:

  • An interdisciplinary initiative in Zimbabwe to establish a multimorbidity-learning health system.
  • Focus on three sociotechnical infrastructure domains: reengineered electronic health records (EHR), deliberative platforms, and learning sites.
  • EHR integration for research, data, and decision support; platforms for knowledge translation; learning sites for integrated care models.

Main Results:

  • Demonstrated a model for integrating research, data, and decision support through reengineered EHR.
  • Facilitated multi-condition sense-making and knowledge translation via deliberative platforms.
  • Enabled practical development and iteration of integrated treatment and prevention models at service delivery levels.

Conclusions:

  • LHS provide a viable framework for health systems to become more integrated, adaptive, and self-reliant in managing multimorbidity.
  • The Zimbabwean initiative highlights key infrastructural domains and mechanisms applicable to lower-income countries.
  • Developing in-house learning capabilities is crucial for addressing the needs of aging, multimorbid populations with reduced external funding.