Assembling the Challenge of Multimorbidity in Zimbabwe: A Participatory Ethnographic Study DOI Creative Commons
Justin Dixon,

Efison Dhodho,

Fionah Mundoga

и другие.

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

Multimorbidity and health system priorities in Zimbabwe: A participatory ethnographic study DOI Creative Commons
Justin Dixon,

Efison Dhodho,

Fionah Mundoga

и другие.

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

Процитировано

0
Exploring the workload of informal caregiving in the context of HIV/NCD multimorbidity in South Africa DOI Creative Commons
Myrna van Pinxteren, Charlotte Slome, Frances S Mair

и другие.

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

Процитировано

0
Assembling the Challenge of Multimorbidity in Zimbabwe: A Participatory Ethnographic Study DOI Creative Commons
Justin Dixon,

Efison Dhodho,

Fionah Mundoga

и другие.

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

Процитировано

0