12 November 2019

Disruption, changes, and adaptation

The gendered implications of chronic conditions in Mozambique, Nepal and Peru

Maria Amalia Pesantes, Claire Somerville, Suman Bahadur Singh, Silvana Perez-Leon, Tavares Madede, Suzanne Suggs and David Beran. 2019. Disruption, changes, and adaptation: Experiences with chronic conditions in Mozambique, Nepal and Peru. Global Public Health. DOI: 10.1080/17441692.2019.1668453

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. The authors analysed their data using the concepts of disruption and adaptive strategies, finding that although the countries are very different, the implications in daily lives, interpersonal relationships, and family dynamics are similar, and that oftentimes such impact is defined along gender lines. The authors 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. The findings highlight the relevance of understanding the challenges of developing adaptive solutions to chronic care in resource-scarce contexts.


Banner: A pharmacy in Kathmandu, Nepal. © Milosz Maslanka/