Addressing Multimorbidity Health Needs in Rural South Africa
Understanding the Growing Burden
The burden of non-communicable diseases, such as hypertension and diabetes, is on the rise globally. This is particularly challenging in low-income and middle-income countries where they coexist with epidemics of communicable diseases like HIV. A comprehensive public health survey led by Dr. Emily Wong in South Africa has sought to assess the multimorbidity health needs in rural KwaZulu-Natal. Their study establishes a framework to quantify both met and unmet health needs for individuals grappling with infectious and non-communicable diseases. This research, providing crucial insights, is published in The Lancet Global Health.
A Glimpse into the Research
This pioneering framework underscores that approximately half of the population in a South African community living with HIV, diabetes, or hypertension has unmet health needs. Notably, the unmet needs are more pronounced in individuals with non-communicable diseases. Dr. Wong, who was part of this study, emphasizes the potential of this framework in helping countries assess their health programs, identify areas that require intervention, and consider integrated approaches for managing communicable and non-communicable diseases. In the context of South Africa, it suggests that the health systems effectively meeting the needs of people with HIV could serve as a model for addressing the diagnostic and care requirements of those with diabetes and hypertension.
A Data-Driven Approach
To arrive at these findings, the researchers delved into data from the Vukuzazi survey, covering 18,041 participants between 2018 and 2020. They introduced a novel framework that assigned health needs scores to different health states for each disease. These states ranged from free of the condition to diagnosed, engaged in care, optimally treated, and more. The area surveyed had a significant HIV prevalence, with access to antiretroviral therapy available through public health clinics since 2004.
Key Findings
The research revealed that 54.9% of the participants had at least one of the three chronic diseases studied. Among these, 49.9% had at least one unmet health need. These unmet needs varied by disease; for instance, 93.1% of individuals who screened positive for diabetes had unmet health needs, compared to 58.2% for hypertension and 21.7% for HIV. The met health needs for HIV were widespread geospatially, while the unmet health needs for all three conditions were concentrated in specific areas.
Addressing Discrepancies
Dr. Wong highlights a notable discrepancy in the South African health system’s ability to address health needs. While the system effectively responds to communicable diseases, it falls short in meeting the requirements of people with non-communicable diseases. This research indicates a significant need for improved non-communicable disease care in rural South Africa. As health systems have a broad reach for HIV care, adapting existing programs and frameworks can successfully address multiple chronic diseases concurrently.
Contributors and Support
This study brought together a collaborative effort, with contributions from numerous individuals and institutions in South Africa, the United States, and the United Kingdom. It was supported by various organizations, including the Fogarty International Center, the National Institutes of Health, the Bill & Melinda Gates Foundation, and others.
This research not only sheds light on the growing challenges posed by non-communicable diseases but also lays the groundwork for more effective and integrated healthcare responses to these complex health needs.
Erin Balsa is a highly skilled and knowledgeable health journalist with a passion for educating the public on important health and wellness topics. With extensive experience in both traditional and digital media, Erin has established herself as a trusted voice in the field.