Study setting

This research was nested within the Developmental Pathways for Health Research Unit, which is part of the University of the Witwatersrand and located at Chris Hani Baragwanath Academic Hospital in Soweto, South Africa. Soweto is a low-income neighborhood within the expansive land-locked city of Johannesburg, South Africa, famous for its incorporation of six townships. Today more than one million people reside in Soweto and most are black South Africans, representing various ethnic identities (e.g. Xhosa, Sotho, etc.). Soweto is diverse economically, including middle-class neighborhoods, working class communities, and informal settlements. Residents report an elevated affliction of infectious conditions like HIV and TB and non-communicable diseases, such as hypertension, type 2 diabetes, and depression. The prevalence of multimorbidity is high, which is compounded by costly health care services in the private sector and systemic barriers in the public sector.