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

Justin Dixon, Ben Morton, Misheck J. Nkhata, Alan Silman, Ibrahim G. Simiyu, Stephen A. Spencer, Myrna Van Pinxteren, Christopher Bunn, Claire Calderwood, Clare I.R. Chandler, Edith Chikumbu, Amelia C. Crampin, John R. Hurst, Modou Jobe, Andre Pascal Kengne, Naomi S. Levitt, Mosa Moshabela, Mayowa Owolabi, Nasheeta Peer, Nozgechi PhiriSally J. Singh, Tsaone Tamuhla, Mandikudza Tembo, Nicki Tiffin, Eve Worrall, Nateiya M. Yongolo, Gift T. Banda, Fanuel Bickton, Abbi Monique Mamani Bilungula, Edna Bosire, Marlen S. Chawani, Beatrice Chinoko, Mphatso Chisala, Jonathan Chiwanda, Sarah Drew, Lindsay Farrant, Rashida A. Ferrand, Mtisunge Gondwe, Celia L. Gregson, Richard Harding, Dan Kajungu, Stephen Kasenda, Winceslaus Katagira, Duncan Kwaitana, Emily Mendenhall, Adwoa Bemah Boamah Mensah, Modai Mnenula, Lovemore Mupaza, Maud Mwakasungula, Wisdom Nakanga, Chiratidzo Ndhlovu, Kennedy Nkhoma, Owen Nkoka, Edwina Addo Opare-Lokko, Jacob Phulusa, Alison Price, Jamie Rylance, Charity Salima, Sangwani Salimu, Joachim Sturmberg, Elizabeth Vale, Felix Limbani

Research output: Contribution to journalArticlepeer-review

Abstract

Multimorbidity is an emerging challenge for health systems globally. It is commonly defined as the co-occurrence of two or more chronic conditions in one person, but its meaning remains a lively area of academic debate, and the utility of the concept beyond high-income settings is uncertain. This article presents the findings from an interdisciplinary research initiative that drew together 60 academic and applied partners working in 10 African countries to answer the questions: how useful is the concept of multimorbidity within Africa? Can the concept be adapted to context to optimise its transformative potentials? During a three-day concept-building workshop, we investigated how the definition of multimorbidity was understood across diverse disciplinary and regional perspectives, evaluated the utility and limitations of existing concepts and definitions, and considered how to build a more context-sensitive, cross-cutting description of multimorbidity. This iterative process was guided by the principles of grounded theory and involved focus- and whole-group discussions during the workshop, thematic coding of workshop discussions, and further post-workshop development and refinement. Three thematic domains emerged from workshop discussions: the current focus of multimorbidity on constituent diseases; the potential for revised concepts to centre the priorities, needs, and social context of people living with multimorbidity (PLWMM); and the need for revised concepts to respond to varied conceptual priorities amongst stakeholders. These themes fed into the development of an expanded conceptual model that centres the catastrophic impacts multimorbidity can have for PLWMM, families and support structures, service providers, and health systems.

Original languageEnglish
Article numbere0003434
JournalPLOS Global Public Health
Volume4
Issue number7
DOIs
Publication statusPublished - 30 Jul 2024

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