Why the number of people with more than one chronic condition is rising in Africa

Chronic conditions are on a rise in every part of the world owing to both environmental and lifestyle factors. For example, people are increasingly affected by two of the most common non-infectious chronic conditions viz, diabetes and hypertension. Moreover, the world is also witnessing a rise in HIV patients as well as an environmental health condition asthma, which is crippling even newborn babies.

Africa, in its entirety, has also become vulnerable to chronic diseases that are crippling its population, especially more than one at a time, which is hard to manage. This concept of having more than one chronic health disease at one time is known as multimorbidity. 

While conventionally, developed countries shared a high inclination to such non-contagious chronic conditions, mostly hypertension and diabetes, developing countries are now falling into the category of developing multimorbidity. 

These increasing cases mostly include hypertension, which is one of the most common co-morbid health conditions that is non-contagious to exist in the world. Moreover, the cases of multimorbidity are increasing at an alarming rate that seems to have been a priority concern for the African health structure.

Scientists associate the high momentum of the multimorbidity condition to rapid urbanization and a change in lifestyles such as dietary habits, sedentary lifestyle, behavioural patterns, and the intake of more salt and sugar through packaged food.

Along with this, the fast-paced lifestyle has created a burden on African families where people resort to tobacco and alcohol use, which is further associated with the likelihood of multimorbidity. In Africa, the issue is graver than imagined since most of the population is already economically and socially vulnerable. The continent has a high elderly population that lacks a proper socio-economic stature and is not educated. 

Lack of education restricts the people of socially backward regions to be aware of the prognosis or diagnosis of these conditions. This often leads to denial about the health-related repercussions of such non-contagious chronic conditions. This poses a critical challenge to the health care sector of Africa for identifying the cases and making them aware of the condition before it is addressed. 

Chronic Health Conditions: Affecting the patient and the system

The consequences of multimorbidity are three-fold:

It affects the patient

It affects the health care provider 

It affects the health system as a whole.

Multimorbidity deteriorates the quality of life to a great extent and poses a serious health risk to the ones affected. The co-existence of more than one chronic non-contagious condition often results in the loss of potential income sources for the family, causes an extra financial burden, and brings psychological burden on the patient. 

The addition of psychological burden, often manifested as depression to the already existing chronic condition degrades the self-management needs and causes the condition to become more complex to be treated. 

This, when viewed from the health care provider’s perspective becomes complex owing to the inadequate preparation to deal with more than one condition. While healthcare provider needs more data and information on the condition and drug interaction, their burden spikes are not efficiently managed by the health care system. 

Managing the chronic health problem

To start tackling the problem, the health care system needs to identify the reasons that cause multimorbidity. The policymakers and health care professionals need to engage in multiple sectors, including the environmental and social causes that drive these health problems. This might include running campaigns, including local schools, hospitals, social services, and media to raise awareness at the ground level. 

Perceived steps

In Africa, multimorbidity is expected to impose an enhanced strain on the already drained health care system. Therefore, the continent requires a structure and a strategic approach to manage the problem at its root cause. This must incorporate an in-depth understanding of Africa’s distinct patterns of multimorbidity, its root cause, and strategic focus on prevention.