Multimorbidity matters in low and middle-income countries
Date
2022-05-23
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Abstract
Multimorbidity is a complex challenge affecting individuals, families, caregivers, and health systems worldwide. The burden
of multimorbidity is remarkable in low- and middle-income countries (LMICs) given the many existing challenges in these
settings. Investigating multimorbidity in LMICs poses many challenges including the different conditions studied, and the
restriction of data sources to relatively few countries, limiting comparability and representativeness. This has led to a
paucity of evidence on multimorbidity prevalence and trends, disease clusters, and health outcomes, particularly longitudinal outcomes. In this paper, based on our experience of investigating multimorbidity in LMICs contexts, we discuss how
the structure of the health system does not favor addressing multimorbidity, and how this is amplified by social and
economic disparities and, more recently, by the COVID-19 pandemic. We argue that generating epidemiologic data around
multimorbidity with similar methods and definition is essential to improve comparability, guide clinical decision-making and
inform policies, research priorities, and local responses. We call for action on policy to refinance and prioritize primary
care and integrated care as the center of multimorbidity.