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A cross-cultural investigation of the conceptualisation of frailty in northern Tanzania

Published online by Cambridge University Press:  22 April 2021

Emma G. Lewis
Affiliation:
Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK Northumbria Healthcare NHS Foundation Trust, Tyne and Wear, UK
Jane Rogathi
Affiliation:
Kilimanjaro Christian Medical Centre, Moshi, Tanzania Kilimanjaro Christian Medical University College, Moshi, Tanzania
John Kissima
Affiliation:
Hai District Hospital, Boma Ng'ombe, Tanzania
Matthew Breckons
Affiliation:
Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
Richard Lee
Affiliation:
Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
Sarah Urasa
Affiliation:
Kilimanjaro Christian Medical Centre, Moshi, Tanzania Kilimanjaro Christian Medical University College, Moshi, Tanzania
Corresponding
E-mail address:

Abstract

Frailty prevalence is higher in low- and middle-income countries (LMICs) compared with high-income countries when measured by biomedical frailty models, the most widely used being the frailty phenotype. Frailty in older people is becoming of global public health interest as a means of promoting health in old age in LMICs. As yet, little work has been done to establish to what extent the concept of frailty, as conceived according to ‘western’ biomedicine, has cross-cultural resonance for a low-income rural African setting. This study aimed to investigate the meaning of frailty contextually, using the biomedical concept of the frailty phenotype as a framework. Qualitative interviews were conducted with a purposive sample of older adults, their care-givers and community representatives in rural northern Tanzania. Thirty interview transcripts were transcribed, translated from Kiswahili to English and thematically analysed. Results reveal that despite superficial similarities in the understanding of frailty, to a great extent the physical changes highlighted by the frailty phenotype were naturalised, except when these were felt to be due to a scarcity of resources. Frailty was conceptualised as less of a physical problem of the individual, but rather, as a social problem of the community, suggesting that the frailty construct may be usefully applied cross-culturally when taking a social equity focus to the health of older people in LMICs.

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Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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