Disruption, changes, and adaptation: Experiences with chronic conditions in Mozambique, Nepal and Peru

ABSTRACT

Chronic conditions are an increasing problem in Low- and Middle-Income Countries (LMICs) yet, the challenges faced by low-income populations with these conditions in such countries are not well understood. Based on in-depth interviews with people affected by chronic conditions and their family members, this paper describes the experience of patients suffering from diabetes or hypertension in rural communities of Mozambique, Nepal, and Peru. We analysed our data using the concepts of disruption and adaptive strategies, finding that despite being very different countries, the implications in daily lives, interpersonal relationships, and family dynamics are similar, and that oftentimes such impact is defined along gender lines. We show that adjustments to living with a chronic disease are not always easy, particularly when they imply changes and reconfiguration of roles and responsibilities for which neither the individual nor their families are prepared. The study adds to the literature on the disruptive effects of chronic conditions and stresses the importance of contextualising disruptive experiences among disadvantaged populations within weak health systems. Our findings highlight the relevance of understanding the challenges of developing adaptive solutions to chronic care in resource-scarce contexts.

KEYWORDS:

• Chronic conditions
• disruption
• Mozambique
• Peru
• Nepal

Acknowledgements

We would like to thank all the people from the communities for sharing their time and their stories. We would also like to thank Dr Khatia Munguambe for her support during the design of the methodology and the data collection process in Mozambique. We also want to acknowledge the support from Jaime Miranda, Albertino Damasceno and Nilambar Jha for their advice at different stages of the research process.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Maria Amalia Pesantes http://orcid.org/0000-0002-0649-3649

Claire Somerville http://orcid.org/0000-0002-2335-160X

Suman Bahadur Singh http://orcid.org/0000-0002-5375-1110

Silvana Perez-Leon http://orcid.org/0000-0003-4860-587X

Tavares Madede http://orcid.org/0000-0001-8194-8597

Suzanne Suggs http://orcid.org/0000-0001-6084-5468

David Beran http://orcid.org/0000-0001-7229-3920

Additional information

Funding

This research is part of the COHESION (COmmunity HEalth System InnovatiON) Project (#160366) and is funded by the Swiss National Science Foundation (Schweizerischer Nationalfonds zur Forderung der Wissenschaftlichen Forschungand) and the Swiss Development Cooperation under the Swiss Program for Research on Global Issues for Development.