Patients, providers, and systems: local models for chronic care and self-management support in southern Malawi

Countries in sub-Saharan Africa are faced with the double burden of chronic communicable and non-communicable diseases. Addressing these health system challenges requires bolstering the approaches in the organisation and provision of health services to meet the escalating demands for long term care. This thesis seeks to understand and contextualize the challenges and opportunities within local health systems in resource-limited settings, as they strive to reorient towards delivering responsive chronic care at scale. Second, the thesis seeks to generate evidence of the local innovations and practices of self-management, considered a critical principle in chronic disease management within these settings. This research was conducted in Phalombe district, southern Malawi in 2016 to 2017.