Exploring treatment burden and capacity for self care among patients with HIV/NCD multimorbidity in South Africa to inform interventions (EXTRA)
Medical Research Council
University of Cape Town
In Sub-Saharan Africa the rising burden of non-communicable diseases (NCDs) against a background of chronic infectious disease epidemics, most notably HIV, is giving rise to patterns of multimorbidy that are occurring in people of working age, with implications for productivity and social stability. Chronic care for patients with multimorbidity in South Africa (SA) is fragmented, uncoordinated and does not account for increased complexity of the demands on patients. We aim to systematically identify, characterize and understand the workload experienced by patients with HIV/NCD multimorbidity, and their caregivers in SA. This is to ensure that the patient perspective is fully considered in current healthcare reform initiatives to improve primary level chronic care and outcomes. We further aim to explore the relevance and applicability of existing theoretical models of NCD treatment workload-capacity from high income countries and adapt them to inform future research and interventions in the LMIC context of SA. We will use qualitative research methods to: conduct semi-structured interviews with purposively selected samples of patient and carer dyads in urban and rural settings; convene task groups with healthcare decision makers, doctors, nurses and community health workers from the same settings to discuss the findings and consider their implications for local service redesign and interventions to reduce burden and increase capacity; engage policy and decision makers provincially and nationally in stakeholder meetings to influence health reforms. This project will help us better understand treatment and capacity issues in a LMIC context. Our theory-informed qualitative analyses will develop a culturally and contextually appropriate theoretical model of HIV/NCD workload and capacity. This work will contribute to development of individual, peer group and service level interventions that can be validated in a large scale, complex intervention trial.
7.1 Individual care needs / P&Cs