Barriers and facilitators to the implementation of a community-based hypertension improvement project in Ghana: a qualitative study of ComHIP
Abstract Background Globally, hypertension is a leading cause of cardiovascular disease and mortality, with the majority of deaths occurring in low- and middle-income countries. Because the burden of hypertension is increasing in low resource settings with restricted infrastructure, it is imperative...
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| Format: | Article |
| Language: | English |
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BMC
2020-01-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-019-4774-x |
| _version_ | 1819176567470817280 |
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| author | Alma J. Adler Amos K. Laar Agnes M. Kotoh Helena Legido-Quigley Pablo Perel Peter Lamptey Isabelle L. Lange |
| author_facet | Alma J. Adler Amos K. Laar Agnes M. Kotoh Helena Legido-Quigley Pablo Perel Peter Lamptey Isabelle L. Lange |
| author_sort | Alma J. Adler |
| collection | DOAJ |
| description | Abstract Background Globally, hypertension is a leading cause of cardiovascular disease and mortality, with the majority of deaths occurring in low- and middle-income countries. Because the burden of hypertension is increasing in low resource settings with restricted infrastructure, it is imperative that new models for hypertension care are realised. One such model is the Community-based Hypertension Improvement Project (ComHIP) which employs a community-based method of task-shifting for managing hypertension. This study is a qualitative analysis of the barriers and facilitators of the main components of ComHIP. Methods We purposively selected 55 informants for semi-structured interviews or focus group discussions, which were carried out bythree trained local researchers in Krobo, Twi or English. Informants included patients enrolled in ComHIP, health care providers and Licensed Chemical Sellers trained by ComHIP, and Ghana Health Service employees. Data were analysed using a multi-step thematic analysis. Results While results of the effectiveness of the intervention are pending, overall, patients and nurses reported positive experiences within ComHIP, and found that it helped enable them to manage their hypertension. Healthcare providers appreciated the additional training, but had some gaps in their knowledge. Ghana Health Service employees were cautiously optimistic about the programme, but expressed some worries about the sustainability of the programme. Many informants expressed concerns over the inability of community nurses and workers to dispense anti-hypertensives, due to legal restrictions. Conclusions The WHO recommends task-sharing as a technique for managing chronic conditions such as hypertension in resource constrained settings. ComHIP presents an example of a task-sharing programme with a high level of acceptability to all participants. Going forward, we recommend greater levels of communication and dialogue to allow community-based health workers to be allowed to dispense anti-hypertensives. |
| first_indexed | 2024-12-22T21:12:49Z |
| format | Article |
| id | doaj.art-02b0bc5f36c54dbcb3cfc0f2f805224d |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-22T21:12:49Z |
| publishDate | 2020-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-02b0bc5f36c54dbcb3cfc0f2f805224d2022-12-21T18:12:27ZengBMCBMC Health Services Research1472-69632020-01-0120111310.1186/s12913-019-4774-xBarriers and facilitators to the implementation of a community-based hypertension improvement project in Ghana: a qualitative study of ComHIPAlma J. Adler0Amos K. Laar1Agnes M. Kotoh2Helena Legido-Quigley3Pablo Perel4Peter Lamptey5Isabelle L. Lange6Department of Global Health and Social Medicine, Harvard Medical School BostonDepartment of Population, Family, & Reproductive Health, School of Public Health, University of GhanaDepartment of Population, Family, & Reproductive Health, School of Public Health, University of GhanaDepartment of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical MedicineDepartment of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical MedicineDepartment of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical MedicineDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical MedicineAbstract Background Globally, hypertension is a leading cause of cardiovascular disease and mortality, with the majority of deaths occurring in low- and middle-income countries. Because the burden of hypertension is increasing in low resource settings with restricted infrastructure, it is imperative that new models for hypertension care are realised. One such model is the Community-based Hypertension Improvement Project (ComHIP) which employs a community-based method of task-shifting for managing hypertension. This study is a qualitative analysis of the barriers and facilitators of the main components of ComHIP. Methods We purposively selected 55 informants for semi-structured interviews or focus group discussions, which were carried out bythree trained local researchers in Krobo, Twi or English. Informants included patients enrolled in ComHIP, health care providers and Licensed Chemical Sellers trained by ComHIP, and Ghana Health Service employees. Data were analysed using a multi-step thematic analysis. Results While results of the effectiveness of the intervention are pending, overall, patients and nurses reported positive experiences within ComHIP, and found that it helped enable them to manage their hypertension. Healthcare providers appreciated the additional training, but had some gaps in their knowledge. Ghana Health Service employees were cautiously optimistic about the programme, but expressed some worries about the sustainability of the programme. Many informants expressed concerns over the inability of community nurses and workers to dispense anti-hypertensives, due to legal restrictions. Conclusions The WHO recommends task-sharing as a technique for managing chronic conditions such as hypertension in resource constrained settings. ComHIP presents an example of a task-sharing programme with a high level of acceptability to all participants. Going forward, we recommend greater levels of communication and dialogue to allow community-based health workers to be allowed to dispense anti-hypertensives.https://doi.org/10.1186/s12913-019-4774-xHypertensionImplementation researchFacilitatorsGhanaCommunity-basedQualitative research |
| spellingShingle | Alma J. Adler Amos K. Laar Agnes M. Kotoh Helena Legido-Quigley Pablo Perel Peter Lamptey Isabelle L. Lange Barriers and facilitators to the implementation of a community-based hypertension improvement project in Ghana: a qualitative study of ComHIP BMC Health Services Research Hypertension Implementation research Facilitators Ghana Community-based Qualitative research |
| title | Barriers and facilitators to the implementation of a community-based hypertension improvement project in Ghana: a qualitative study of ComHIP |
| title_full | Barriers and facilitators to the implementation of a community-based hypertension improvement project in Ghana: a qualitative study of ComHIP |
| title_fullStr | Barriers and facilitators to the implementation of a community-based hypertension improvement project in Ghana: a qualitative study of ComHIP |
| title_full_unstemmed | Barriers and facilitators to the implementation of a community-based hypertension improvement project in Ghana: a qualitative study of ComHIP |
| title_short | Barriers and facilitators to the implementation of a community-based hypertension improvement project in Ghana: a qualitative study of ComHIP |
| title_sort | barriers and facilitators to the implementation of a community based hypertension improvement project in ghana a qualitative study of comhip |
| topic | Hypertension Implementation research Facilitators Ghana Community-based Qualitative research |
| url | https://doi.org/10.1186/s12913-019-4774-x |
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