{"id":"https://openalex.org/W7214707453","doi":"https://doi.org/10.64898/2026.09.28.26364151","title":"Learning to integrate? Multimorbidity, chronic care and health system adaptation in post-USAID Zimbabwe","display_name":"Learning to integrate? Multimorbidity, chronic care and health system adaptation in post-USAID Zimbabwe","publication_year":2026,"publication_date":"2026-09-29","ids":{"openalex":"https://openalex.org/W7214707453","doi":"https://doi.org/10.64898/2026.09.28.26364151"},"language":"en","primary_location":{"id":"doi:10.64898/2026.09.28.26364151","doi":"https://doi.org/10.64898/2026.09.28.26364151","is_oa":false,"landing_page_url":"https://doi.org/10.64898/2026.09.28.26364151","pdf_url":null,"source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":null,"license_id":null,"version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5106343619","display_name":"Fionah Mundoga","orcid":"https://orcid.org/0009-0006-4874-908X","observed_orcids":["https://orcid.org/0009-0006-4874-908X"]},"institutions":[{"id":"https://openalex.org/I4210099665","display_name":"Biomedical Research and Training Institute","ror":"https://ror.org/0130vhy65","country_code":"ZW","type":"healthcare","lineage":["https://openalex.org/I4210099665"]}],"countries":["ZW"],"is_corresponding":false,"raw_author_name":"Fionah Mundoga","raw_affiliation_strings":["Organization for Public Health Interventions and Development, Harare, Zimbabwe (OPHID)","The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe"],"raw_orcid":"https://orcid.org/0009-0006-4874-908X","affiliations":[{"raw_affiliation_string":"Organization for Public Health Interventions and Development, Harare, Zimbabwe (OPHID)","institution_ids":[]},{"raw_affiliation_string":"The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe","institution_ids":["https://openalex.org/I4210099665"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5126430777","display_name":"Kety Choga","orcid":"https://orcid.org/0009-0001-0356-048X","observed_orcids":["https://orcid.org/0009-0001-0356-048X"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Kety Choga","raw_affiliation_strings":["Organization for Public Health Interventions and Development, Harare, Zimbabwe (OPHID)"],"raw_orcid":"https://orcid.org/0009-0001-0356-048X","affiliations":[{"raw_affiliation_string":"Organization for Public Health Interventions and Development, Harare, Zimbabwe (OPHID)","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5038688219","display_name":"Karen A Webb","orcid":"https://orcid.org/0000-0002-9664-100X","observed_orcids":["https://orcid.org/0000-0002-9664-100X","https://orcid.org/0000-0002-4015-2581"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Karen Webb","raw_affiliation_strings":["Organization for Public Health Interventions and Development, Harare, Zimbabwe (OPHID)"],"raw_orcid":"https://orcid.org/0000-0002-9664-100X","affiliations":[{"raw_affiliation_string":"Organization for Public Health Interventions and Development, Harare, Zimbabwe (OPHID)","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5141149140","display_name":"Patience Mangisi","orcid":"https://orcid.org/0009-0007-3698-0492","observed_orcids":["https://orcid.org/0009-0007-3698-0492"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Patience Mangisi","raw_affiliation_strings":["Ministry of Health and Child Care (MoHCC)"],"raw_orcid":"https://orcid.org/0009-0007-3698-0492","affiliations":[{"raw_affiliation_string":"Ministry of Health and Child Care (MoHCC)","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5141148032","display_name":"Shingairayi Tsvangirayi","orcid":"https://orcid.org/0009-0003-5159-8540","observed_orcids":["https://orcid.org/0009-0003-5159-8540"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Shingairai Tsvangirayi","raw_affiliation_strings":["Ministry of Health and Child Care (MoHCC)"],"raw_orcid":"https://orcid.org/0009-0003-5159-8540","affiliations":[{"raw_affiliation_string":"Ministry of Health and Child Care (MoHCC)","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5153543234","display_name":"Valient Makore","orcid":"https://orcid.org/0009-0003-9015-5777","observed_orcids":["https://orcid.org/0009-0003-9015-5777"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Valient Makore","raw_affiliation_strings":["Ministry of Health and Child Care (MoHCC)"],"raw_orcid":"https://orcid.org/0009-0003-9015-5777","affiliations":[{"raw_affiliation_string":"Ministry of Health and Child Care (MoHCC)","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5073791038","display_name":"Agnes Katsidzira","orcid":"https://orcid.org/0009-0009-5598-3108","observed_orcids":["https://orcid.org/0009-0009-5598-3108"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Agnes Katsidzira","raw_affiliation_strings":["AIDS Healthcare Foundation, Harare"],"raw_orcid":"https://orcid.org/0009-0009-5598-3108","affiliations":[{"raw_affiliation_string":"AIDS Healthcare Foundation, Harare","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5036760010","display_name":"Clorata Gwanzura","orcid":"https://orcid.org/0009-0009-6265-0950","observed_orcids":["https://orcid.org/0009-0009-6265-0950"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Clorata Gwanzura","raw_affiliation_strings":["Ministry of Health and Child Care (MoHCC)"],"raw_orcid":"https://orcid.org/0009-0009-6265-0950","affiliations":[{"raw_affiliation_string":"Ministry of Health and Child Care (MoHCC)","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5062962133","display_name":"Tsitsi Apollo","orcid":"https://orcid.org/0000-0001-9881-0914","observed_orcids":["https://orcid.org/0000-0001-9881-0914"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Tsitsi Apollo","raw_affiliation_strings":["Ministry of Health and Child Care (MoHCC)"],"raw_orcid":"https://orcid.org/0000-0001-9881-0914","affiliations":[{"raw_affiliation_string":"Ministry of Health and Child Care (MoHCC)","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5050502575","display_name":"Cleophas Chimbetete","orcid":"https://orcid.org/0000-0002-3756-3523","observed_orcids":["https://orcid.org/0000-0002-3756-3523"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Cleophas Chimbetete","raw_affiliation_strings":["Newlands Clinic, Harare"],"raw_orcid":"https://orcid.org/0000-0002-3756-3523","affiliations":[{"raw_affiliation_string":"Newlands Clinic, Harare","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5106343620","display_name":"Trudy Mhlanga","orcid":"https://orcid.org/0009-0004-1379-3748","observed_orcids":["https://orcid.org/0009-0004-1379-3748"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Trudy Mhlanga","raw_affiliation_strings":["Organization for Public Health Interventions and Development, Harare, Zimbabwe (OPHID)"],"raw_orcid":"https://orcid.org/0009-0004-1379-3748","affiliations":[{"raw_affiliation_string":"Organization for Public Health Interventions and Development, Harare, Zimbabwe (OPHID)","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5067089708","display_name":"Pugie Tawanda Chimberengwa","orcid":"https://orcid.org/0000-0002-4051-0916","observed_orcids":["https://orcid.org/0000-0002-4051-0916"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Pugie Chimberengwa","raw_affiliation_strings":["Organization for Public Health Interventions and Development, Harare, Zimbabwe (OPHID)"],"raw_orcid":"https://orcid.org/0000-0002-4051-0916","affiliations":[{"raw_affiliation_string":"Organization for Public Health Interventions and Development, Harare, Zimbabwe (OPHID)","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5099013883","display_name":"Theonevus Tinashe Chinyanga","orcid":"https://orcid.org/0000-0002-4881-712X","observed_orcids":["https://orcid.org/0000-0002-4881-712X"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Theonevus T. Chinyanga","raw_affiliation_strings":["Organization for Public Health Interventions and Development, Harare, Zimbabwe (OPHID)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Organization for Public Health Interventions and Development, Harare, Zimbabwe (OPHID)","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5106343618","display_name":"Efison Dhodho","orcid":"https://orcid.org/0000-0002-0943-146X","observed_orcids":["https://orcid.org/0000-0002-0943-146X"]},"institutions":[{"id":"https://openalex.org/I4210089966","display_name":"London School of Hygiene & Tropical Medicine","ror":"https://ror.org/00a0jsq62","country_code":"GB","type":"education","lineage":["https://openalex.org/I124357947","https://openalex.org/I4210089966"]},{"id":"https://openalex.org/I4210099665","display_name":"Biomedical Research and Training Institute","ror":"https://ror.org/0130vhy65","country_code":"ZW","type":"healthcare","lineage":["https://openalex.org/I4210099665"]}],"countries":["GB","ZW"],"is_corresponding":false,"raw_author_name":"Efison Dhodho","raw_affiliation_strings":["Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK","Organization for Public Health Interventions and Development, Harare, Zimbabwe (OPHID)","The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe"],"raw_orcid":"https://orcid.org/0000-0002-0943-146X","affiliations":[{"raw_affiliation_string":"Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK","institution_ids":["https://openalex.org/I4210089966"]},{"raw_affiliation_string":"Organization for Public Health Interventions and Development, Harare, Zimbabwe (OPHID)","institution_ids":[]},{"raw_affiliation_string":"The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe","institution_ids":["https://openalex.org/I4210099665"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5041107881","display_name":"Justin Dixon","orcid":"https://orcid.org/0000-0002-7706-7305","observed_orcids":["https://orcid.org/0000-0002-7706-7305"]},"institutions":[{"id":"https://openalex.org/I4210089966","display_name":"London School of Hygiene & Tropical Medicine","ror":"https://ror.org/00a0jsq62","country_code":"GB","type":"education","lineage":["https://openalex.org/I124357947","https://openalex.org/I4210089966"]},{"id":"https://openalex.org/I4210099665","display_name":"Biomedical Research and Training Institute","ror":"https://ror.org/0130vhy65","country_code":"ZW","type":"healthcare","lineage":["https://openalex.org/I4210099665"]}],"countries":["GB","ZW"],"is_corresponding":false,"raw_author_name":"Justin Dixon","raw_affiliation_strings":["Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK","Organization for Public Health Interventions and Development, Harare, Zimbabwe (OPHID)","The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe"],"raw_orcid":"https://orcid.org/0000-0002-7706-7305","affiliations":[{"raw_affiliation_string":"Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK","institution_ids":["https://openalex.org/I4210089966"]},{"raw_affiliation_string":"Organization for Public Health Interventions and Development, Harare, Zimbabwe (OPHID)","institution_ids":[]},{"raw_affiliation_string":"The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe","institution_ids":["https://openalex.org/I4210099665"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12246","display_name":"Chronic Disease Management Strategies","score":0.9146000146865845,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12246","display_name":"Chronic Disease Management Strategies","score":0.9146000146865845,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11590","display_name":"Primary Care and Health Outcomes","score":0.03790000081062317,"subfield":{"id":"https://openalex.org/subfields/2714","display_name":"Family Practice"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10629","display_name":"Health Policy Implementation Science","score":0.015200000256299973,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/multimorbidity","display_name":"multimorbidity","score":0.9990000128746033},{"id":"https://openalex.org/keywords/primary-care","display_name":"primary care","score":0.6420000195503235},{"id":"https://openalex.org/keywords/learning-health-systems","display_name":"learning health systems","score":0.8410000205039978},{"id":"https://openalex.org/keywords/health-system-adaptation","display_name":"health system adaptation","score":0.9139999747276306},{"id":"https://openalex.org/keywords/differentiated-service-delivery","display_name":"differentiated service delivery","score":0.9419999718666077},{"id":"https://openalex.org/keywords/fragmentation-of-care","display_name":"care fragmentation","score":0.4970000088214874},{"id":"https://openalex.org/keywords/patient-journey-mapping","display_name":"patient journey mapping","score":0.7250000238418579},{"id":"https://openalex.org/keywords/person-centred-care","display_name":"person-centred care","score":0.7699999809265137},{"id":"https://openalex.org/keywords/health-information-systems","display_name":"health information systems","score":0.5019999742507935}],"concepts":[{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.5687999725341797},{"id":"https://openalex.org/C164429055","wikidata":"https://www.wikidata.org/wiki/Q2070165","display_name":"Institutionalisation","level":2,"score":0.5654000043869019},{"id":"https://openalex.org/C2776807786","wikidata":"https://www.wikidata.org/wiki/Q5113964","display_name":"Chronic care","level":3,"score":0.5267999768257141},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.5199999809265137},{"id":"https://openalex.org/C158739034","wikidata":"https://www.wikidata.org/wiki/Q1907114","display_name":"Metropolitan area","level":2,"score":0.5117999911308289},{"id":"https://openalex.org/C139807058","wikidata":"https://www.wikidata.org/wiki/Q352374","display_name":"Adaptation (eye)","level":2,"score":0.4754999876022339},{"id":"https://openalex.org/C68595000","wikidata":"https://www.wikidata.org/wiki/Q2274177","display_name":"Service delivery framework","level":3,"score":0.41830000281333923},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.41670000553131104},{"id":"https://openalex.org/C2988170871","wikidata":"https://www.wikidata.org/wiki/Q11000047","display_name":"Healthcare system","level":3,"score":0.41339999437332153},{"id":"https://openalex.org/C2780791683","wikidata":"https://www.wikidata.org/wiki/Q846785","display_name":"Action (physics)","level":2,"score":0.4023999869823456},{"id":"https://openalex.org/C47344431","wikidata":"https://www.wikidata.org/wiki/Q1519812","display_name":"Health policy","level":3,"score":0.38589999079704285},{"id":"https://openalex.org/C53173841","wikidata":"https://www.wikidata.org/wiki/Q1897444","display_name":"Action research","level":2,"score":0.3668999969959259},{"id":"https://openalex.org/C2987552334","wikidata":"https://www.wikidata.org/wiki/Q383126","display_name":"Chronic disease","level":2,"score":0.365200012922287},{"id":"https://openalex.org/C194943564","wikidata":"https://www.wikidata.org/wiki/Q1129049","display_name":"Participant observation","level":2,"score":0.36059999465942383},{"id":"https://openalex.org/C39549134","wikidata":"https://www.wikidata.org/wiki/Q133080","display_name":"Public relations","level":1,"score":0.3483999967575073},{"id":"https://openalex.org/C116537","wikidata":"https://www.wikidata.org/wiki/Q2169973","display_name":"Service provider","level":3,"score":0.3456999957561493},{"id":"https://openalex.org/C2779541514","wikidata":"https://www.wikidata.org/wiki/Q1477478","display_name":"Integrated care","level":3,"score":0.34439998865127563},{"id":"https://openalex.org/C2780378061","wikidata":"https://www.wikidata.org/wiki/Q25351891","display_name":"Service (business)","level":2,"score":0.311599999666214},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.3086000084877014},{"id":"https://openalex.org/C179454799","wikidata":"https://www.wikidata.org/wiki/Q132151","display_name":"Ethnography","level":2,"score":0.29679998755455017},{"id":"https://openalex.org/C190248442","wikidata":"https://www.wikidata.org/wiki/Q839486","display_name":"Qualitative research","level":2,"score":0.2928999960422516},{"id":"https://openalex.org/C144024400","wikidata":"https://www.wikidata.org/wiki/Q21201","display_name":"Sociology","level":0,"score":0.28949999809265137},{"id":"https://openalex.org/C98045186","wikidata":"https://www.wikidata.org/wiki/Q205663","display_name":"Process (computing)","level":2,"score":0.2883000075817108},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.2847000062465668},{"id":"https://openalex.org/C163432668","wikidata":"https://www.wikidata.org/wiki/Q623543","display_name":"Primary health care","level":3,"score":0.2824999988079071},{"id":"https://openalex.org/C183759332","wikidata":"https://www.wikidata.org/wiki/Q343680","display_name":"Action learning","level":4,"score":0.27869999408721924},{"id":"https://openalex.org/C2777717087","wikidata":"https://www.wikidata.org/wiki/Q5186711","display_name":"Critical ethnography","level":3,"score":0.27709999680519104},{"id":"https://openalex.org/C2986740045","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health services","level":3,"score":0.274399995803833},{"id":"https://openalex.org/C20555606","wikidata":"https://www.wikidata.org/wiki/Q868575","display_name":"Empowerment","level":2,"score":0.2687000036239624},{"id":"https://openalex.org/C28718268","wikidata":"https://www.wikidata.org/wiki/Q4118620","display_name":"Needs assessment","level":2,"score":0.2630000114440918},{"id":"https://openalex.org/C22467394","wikidata":"https://www.wikidata.org/wiki/Q849359","display_name":"Multidisciplinary approach","level":2,"score":0.2524999976158142},{"id":"https://openalex.org/C2984752397","wikidata":"https://www.wikidata.org/wiki/Q3259956","display_name":"Primary care","level":2,"score":0.25220000743865967}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.64898/2026.09.28.26364151","doi":"https://doi.org/10.64898/2026.09.28.26364151","is_oa":false,"landing_page_url":"https://doi.org/10.64898/2026.09.28.26364151","pdf_url":null,"source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":null,"license_id":null,"version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"}],"best_oa_location":null,"sustainable_development_goals":[{"score":0.9391000270843506,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":27,"referenced_works":["https://openalex.org/W2082998320","https://openalex.org/W2515154115","https://openalex.org/W2593297402","https://openalex.org/W2619478585","https://openalex.org/W2728864698","https://openalex.org/W2790702022","https://openalex.org/W3005713779","https://openalex.org/W3094893438","https://openalex.org/W3130638160","https://openalex.org/W3132069176","https://openalex.org/W3140943953","https://openalex.org/W4220990485","https://openalex.org/W4232092200","https://openalex.org/W4283362767","https://openalex.org/W4296706654","https://openalex.org/W4361214825","https://openalex.org/W4391465440","https://openalex.org/W4401336994","https://openalex.org/W4407308411","https://openalex.org/W4408327276","https://openalex.org/W4409883589","https://openalex.org/W4410160818","https://openalex.org/W4410905523","https://openalex.org/W4410965763","https://openalex.org/W4415011572","https://openalex.org/W7117373568","https://openalex.org/W7130510805"],"related_works":["https://openalex.org/W4401382879","https://openalex.org/W4409883589","https://openalex.org/W7130510805","https://openalex.org/W4412994478","https://openalex.org/W7168778230","https://openalex.org/W6892474891","https://openalex.org/W4411128384","https://openalex.org/W2546910895","https://openalex.org/W7130683004","https://openalex.org/W4283362767"],"abstract_inverted_index":{"Abstract":[0],"Multimorbidity":[1],"exposes":[2],"tensions":[3],"between":[4,111],"complex":[5],"health":[6,9,132,192,262],"needs":[7],"and":[8,29,41,61,67,85,89,114,124,135,187,196,217,228,269],"systems":[10,168],"historically":[11],"organized":[12,169],"vertically":[13],"around":[14,170,208],"single":[15],"diseases.":[16,172],"While":[17],"integrated":[18,216],"chronic":[19,239],"care":[20,164,207,240,248],"has":[21],"become":[22],"a":[23,47,74],"policy":[24,40],"priority":[25],"for":[26,58,69,214,237],"many":[27],"low-":[28],"middle-income":[30],"countries,":[31],"responses":[32],"remain":[33],"constrained":[34,166],"by":[35,148,167],"disease-specific":[36],"configurations":[37],"of":[38,97,160],"knowledge,":[39],"practice.":[42],"The":[43],"USAID":[44],"cuts":[45],"represent":[46],"critical":[48],"rupture":[49],"in":[50,92,104,109,178,183],"these":[51],"arrangements,":[52],"exposing":[53],"dependencies":[54],"while":[55],"creating":[56],"opportunities":[57,68],"integration,":[59],"institutionalisation":[60],"local":[62],"ownership.":[63],"We":[64,99,139],"examined":[65],"challenges":[66],"multimorbidity-responsive":[70,247],"primary":[71,161],"healthcare":[72,128],"through":[73,190,260],"Learning":[75],"Health":[76],"System":[77],"(LHS)":[78],"lens,":[79],"focusing":[80],"on":[81],"how":[82],"information,":[83,185],"deliberation,":[84],"action":[86,270],"shape":[87],"learning":[88,230,258],"adaptation":[90],"processes":[91],"Zimbabwe":[93,110],"during":[94],"this":[95],"period":[96],"transition.":[98],"conducted":[100],"an":[101,144,156],"ethnographic":[102],"study":[103],"two":[105],"urban":[106],"metropolitan":[107],"centers":[108],"October":[112],"2025":[113],"February":[115],"2026,":[116],"using":[117,143],"patient":[118],"journey":[119],"mapping":[120],"(n=23),":[121],"participant":[122],"observation,":[123],"in-depth":[125],"interviews":[126],"with":[127],"workers,":[129],"patients,":[130],"decision-makers,":[131],"information":[133],"specialists,":[134],"technical":[136],"partners":[137],"(n=19).":[138],"analyzed":[140],"data":[141],"thematically":[142],"iterative":[145],"framework":[146],"informed":[147],"LHS":[149],"concepts.":[150],"Participants":[151],"widely":[152],"recognized":[153,195],"multimorbidity":[154],"as":[155,235],"increasingly":[157],"common":[158],"feature":[159],"care,":[162],"yet":[163],"remained":[165],"individual":[171],"Fragmentation":[173],"was":[174],"evident":[175],"not":[176],"only":[177],"clinical":[179],"pathways":[180],"but":[181],"also":[182],"the":[184,200,257],"accountability,":[186],"decision-making":[188],"architectures":[189,259],"which":[191,261],"priorities":[193,263],"were":[194,232],"acted":[197],"upon.":[198],"At":[199],"same":[201],"time,":[202],"frontline":[203],"providers":[204],"routinely":[205],"adapted":[206],"patients\u2019":[209],"multiple":[210],"conditions,":[211],"revealing":[212],"capacity":[213],"more":[215,250],"person-centered":[218],"approaches.":[219],"Existing":[220],"HIV":[221],"platforms,":[222],"including":[223],"differentiated":[224],"service":[225,252],"delivery":[226],"models":[227],"regional":[229],"networks,":[231],"frequently":[233],"identified":[234],"foundations":[236],"broader":[238],"integration.":[241],"These":[242],"findings":[243],"suggest":[244],"that":[245],"advancing":[246],"requires":[249,255],"than":[251],"integration;":[253],"it":[254],"strengthening":[256],"are":[264],"defined,":[265],"knowledge":[266],"is":[267,271],"generated,":[268],"coordinated.":[272]},"counts_by_year":[],"updated_date":"2026-11-08T12:12:28.789561","created_date":"2026-09-30T00:00:00"}