Non-communicable diseases (NCDs) now account for more than 70% of global deaths, with nearly 80% of those occurring in low- and middle-income countries (LMICs), including Sub-Saharan Africa (SSA). The growing burden in SSA is driven by an ageing population and changes in lifestyle, such as poor diets, smoking, alcohol use, and physical inactivity. As a result, multiple long-term chronic NCDs (MLTC-NCDs) are on the rise.
While global prevalence varies, SSA shows a pooled MLTC-NCD prevalence of 26.2%, with rates potentially underestimated due to undiagnosed conditions. Despite this heavy burden, only 5% of global research on multimorbidity is conducted in LMICs. Evidence shows that clusters of cardiometabolic diseases and mental health conditions like depression are among the most common in SSA, often leading to poor quality of life, hospitalizations, and disability.
Countries like Ghana, Kenya, Malawi, and Uganda are seeing rapid increases in NCDs amid demographic shifts. In Ghana, NCDs caused 45% of national deaths in 2019, with half reported as premature. In Kenya, over half of hospital admissions and 40% of deaths are due to NCDs. Malawi and Uganda report 43% and 33% of deaths from NCDs, respectively.
Research shows that urban populations tend to have higher rates of multimorbidity. In Ghana, prevalence among urban women reached 64.8%, while rural women had a lower rate of 49.7%. In Nairobi’s urban slums, nearly 29% of adults aged 40–60 suffer from multimorbidity.
Mental health disorders significantly impact outcomes in patients with cardiometabolic diseases, and vice versa. Depression, in particular, contributes to disability and worsens physical conditions. Yet, mental health services in LMICs are limited, with over 60% of affected individuals lacking access to treatment. While WHO’s mhGAP-IG helps train primary care providers to manage mental health, large-scale, real-world implementation for MLTC patients remains under-researched.
The growing MLTC-NCD epidemic is straining already fragile health systems in SSA, increasing mortality rates, hospital stays, and healthcare costs. Patients with multiple chronic conditions face a 73% higher risk of death compared to those with a single condition. From 1990 to 2017, SSA experienced a 67% rise in NCD-related disability-adjusted life years, underscoring the urgent need for comprehensive interventions. Addressing MLTC-NCDs is now a pressing development and public health priority for the region.
