Multimorbidity and health system priorities in Zimbabwe: A participatory ethnographic study
PLOS Global Public Health,
Год журнала:
2025,
Номер
5(4), С. e0003643 - e0003643
Опубликована: Апрель 28, 2025
Multimorbidity,
increasingly
recognised
as
a
global
health
challenge,
has
recently
emerged
on
the
agendas
of
many
countries
experiencing
rapid
epidemiological
change,
including
in
Africa.
Yet
with
its
conceptual
origins
North,
meaning
and
possible
utility
African
contexts
remains
abstract.
This
study
drew
together
policymakers,
public
practitioners,
academics,
informaticians,
professionals,
people
living
multimorbidity
(PLWMM)
Zimbabwe
to
understand:
What
is
transformative
potential
limitations
elevating
priority
this
setting?
To
bring
these
different
perspectives
into
conversation,
we
used
participatory
ethnographic
design
that
involved
facility
survey,
participant-observation,
in-depth
interviews,
audio-visual
diaries,
workshops.
We
found
was
new
respondents
but
generally
viewed
meaningful
useful
concept.
It
captured
complex
profile
Zimbabwe’s
ageing
population,
foregrounded
range
challenges
related
‘vertical’
organisation
uneven
funding
conditions,
revealed
opportunities
for
integration
across
entrenched
silos
knowledge
practice.
However,
capacity
momentum
address
concentrated
within
HIV
programme,
there
concern
could
itself
become
verticalized,
undercutting
potential.
Participants
agreed
responding
requires
decisive
shift
from
vertical,
disease-centred
programming
restore
comprehensive
primary
care
undergirded
once-renowned
system.
also
means
building
policy-enabling
environment
values
generalist
(as
well
specialist)
knowledge,
ground-level
experience,
inclusive
stakeholder
engagement.
conclude
‘learning’
system
represents
promising
lens
unifying
imperatives,
providing
tangible
framework
how
policy,
practice
synergise
more
self-reliant,
person-centred
systems
able
respond
like
multimorbidity.
Язык: Английский
Exploring the workload of informal caregiving in the context of HIV/NCD multimorbidity in South Africa
PLOS Global Public Health,
Год журнала:
2024,
Номер
4(10), С. e0003782 - e0003782
Опубликована: Окт. 8, 2024
The
importance
of
informal
caregiving
for
chronic
illness
has
been
well
established
in
African
contexts
but
is
underexplored
the
context
HIV/NCD
multimorbidity,
particularly
South
Africa.
Building
on
treatment
burden
theories
that
investigate
workload
illness,
this
paper
explores
how
networks
impact
capacity
people
living
with
multimorbidity
(PLWMM)
low-income
settings
urban
and
rural
Qualitative
semi-structured
interviews
were
carried
out
thirty
sixteen
caregivers
between
February
April
2021
two
settings,
Cape
Town
(urban)
Bulungula
(rural).
Interviews
transcribed
data
analysed
both
inductively
deductively
using
framework
analysis,
hereby,
building
principles
theory
(BoTT)
as
a
theoretical
lens.
Our
findings
show
carers
provided
different
types
support
to
including
emotional,
logistical,
health
services
informational
ease
patient's
burden.
Additional
networks,
access
grants
or
financial
security,
feeling
duty
care
eased
perceived
carer
while
lack
social
support,
hardship
insufficient
information
decreased
their
others.
Overall,
availability
increases
self-management
Informal
structured
through
obligations,
kinship
connections,
cultural
expectations,
an
individual
sense
agency.
Carers,
even
when
committed
assist,
also
experience
opportunity
costs,
which
are
rarely
addressed
literature.
By
proposing
interventions
can
actively
caregivers,
we
begin
develop
solutions
optimize
role
view
improve
health-outcomes
PLWMM
Язык: Английский
Assembling the Challenge of Multimorbidity in Zimbabwe: A Participatory Ethnographic Study
medRxiv (Cold Spring Harbor Laboratory),
Год журнала:
2024,
Номер
unknown
Опубликована: Авг. 7, 2024
Abstract
Multimorbidity,
increasingly
recognised
as
a
global
health
challenge,
has
recently
emerged
on
the
agendas
of
many
lower-income
countries,
including
in
Africa.
Yet
with
its
conceptual
origins
North,
meaning
and
possible
utility
for
stakeholders
lower-resources
settings
remains
abstract.
This
study
drew
together
policymakers,
public
practitioners,
academics,
informaticians,
professionals,
people
living
multimorbidity
(PLWMM)
Zimbabwe
to
understand:
What
is
transformative
potential
limitations
elevating
priority
this
setting?
To
bring
these
different
perspectives
into
conversation,
we
used
participatory
ethnographic
design
that
involved
facility
survey,
participant-observation,
in-depth
interviews,
audio-visual
diaries,
workshops.
found,
was
new
respondents
but
generally
viewed
meaningful
useful
concept.
It
foregrounded
range
challenges
related
‘vertical’
organisation
uneven
funding
diseases,
while
revealing
promising
opportunities
integration
across
entrenched
silos
knowledge
practice.
However,
capacity
momentum
address
currently
concentrated
within
HIV
programme,
there
concern
could
itself
become
verticalized,
undercutting
potential.
Participants
agreed
responding
requires
decisive
shift
from
vertical,
disease-centred
programming
restore
comprehensive
primary
care
undergirded
Zimbabwe’s
once-renowned
system.
also
means
building
policy-enabling
environment
values
generalist
(as
well
specialist)
knowledge,
ground-level
experience,
inclusive
stakeholder
engagement.
The
‘learning’
system,
conclude,
represents
lens
unifying
imperatives,
providing
tangible
framework
how
policy,
practice
synergise
more
self-reliant,
person-centred
systems
able
respond
ever-evolving
complex
like
multimorbidity.
Язык: Английский