However, they also outlined windows of opportunity and facilitators of group medical visits and microfinance to address those challenges. In the context of poverty and previous experiences with the health system, participants described challenges to NCD care across three themes: 1) stigma of chronic disease, 2) earned skepticism of the health system, and 3) socio-economic fragility. A total of 205 individuals (113 men and 92 women) participated in the mabaraza, while 162 individuals (57 men and 105 women) participated in the FGDs. Content analysis was performed with NVivo using deductive and inductive codes that were then grouped into themes. Trained research staff members led the discussions using structured question guides. Two types of qualitative group discussion were conducted: 1) mabaraza (singular, baraza), a traditional East African community gathering used to discuss and exchange information in large group settings and 2) focus group discussions (FGDs) among rural clinicians, community health workers, microfinance group members, and patients with NCDs.
However, the contextual factors, facilitators, and barriers impacting wide-scale implementation of these approaches within a low- and middle-income country setting are not well known. Combining the group-based experience of microfinance and group medical visits is a novel approach to NCD care delivery. Non-communicable diseases (NCDs) are the leading cause of mortality in the world, and innovative approaches to NCD care delivery are being actively developed and evaluated.
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