Assessing Providers’ Approach to Hypertension Management at a Large, Private Hospital in Kampala, Uganda

Background: Hypertension is increasingly prevalent in Uganda and its clinical management remains suboptimal across the country. Prior research has elucidated some of the factors contributing to poor control, but little is known about providers’ approaches to hypertension management and perceptions o...

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Autores principales:	Aliza S. Green, Hayley M. Lynch, Rose Clarke Nanyonga, Allison P. Squires, Darinka D. Gadikota-Klumpers, Jeremy I. Schwartz, David J. Heller
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2020
Materias:	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/df9d4f31485749c1a9a2a8e443b573bf
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spelling	oai:doaj.org-article:df9d4f31485749c1a9a2a8e443b573bf2021-12-02T05:31:14ZAssessing Providers’ Approach to Hypertension Management at a Large, Private Hospital in Kampala, Uganda2214-999610.5334/aogh.2513https://doaj.org/article/df9d4f31485749c1a9a2a8e443b573bf2020-01-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/2513https://doaj.org/toc/2214-9996Background: Hypertension is increasingly prevalent in Uganda and its clinical management remains suboptimal across the country. Prior research has elucidated some of the factors contributing to poor control, but little is known about providers’ approaches to hypertension management and perceptions of barriers to care. This is particularly true in private health care settings – despite the fact that the private sector provides a substantial and growing portion of health care in Uganda. Objective: Our exploratory, pragmatic qualitative study aimed to examine the factors affecting the quality of hypertension care from the perspective of providers working in an urban, private hospital in Uganda. We focused on the organizational and system-level factors influencing providers’ approaches to management in the outpatient setting. Methods: We conducted interviews with 19 health care providers working in the outpatient setting of a 110-bed, private urban hospital in Kampala, Uganda. We then coded the interviews for thematic analysis, using an inductive approach to generate the study’s findings. Findings: Several themes emerged around perceived barriers and facilitators to care. Providers cited patient beliefs and behaviors, driven in part by cultural norms, as key challenges to hypertension control; however, most felt their own approach to hypertension treatment aligned with international guidelines. Providers struggled to collaborate with colleagues in coordinating the joint management of patients. Furthermore, they cited the high cost and limited availability of medication as barriers. Conclusions: These findings offer important strategic direction for intervention development specific to this Ugandan context: for example, regarding culturally-adapted patient education initiatives, or programs to improve access to essential medications. Other settings facing similar challenges scaling up management of hypertension may find the results useful for informing intervention development as well.Aliza S. GreenHayley M. LynchRose Clarke NanyongaAllison P. SquiresDarinka D. Gadikota-KlumpersJeremy I. SchwartzDavid J. HellerUbiquity PressarticleInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 86, Iss 1 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 Aliza S. Green Hayley M. Lynch Rose Clarke Nanyonga Allison P. Squires Darinka D. Gadikota-Klumpers Jeremy I. Schwartz David J. Heller Assessing Providers’ Approach to Hypertension Management at a Large, Private Hospital in Kampala, Uganda
description	Background: Hypertension is increasingly prevalent in Uganda and its clinical management remains suboptimal across the country. Prior research has elucidated some of the factors contributing to poor control, but little is known about providers’ approaches to hypertension management and perceptions of barriers to care. This is particularly true in private health care settings – despite the fact that the private sector provides a substantial and growing portion of health care in Uganda. Objective: Our exploratory, pragmatic qualitative study aimed to examine the factors affecting the quality of hypertension care from the perspective of providers working in an urban, private hospital in Uganda. We focused on the organizational and system-level factors influencing providers’ approaches to management in the outpatient setting. Methods: We conducted interviews with 19 health care providers working in the outpatient setting of a 110-bed, private urban hospital in Kampala, Uganda. We then coded the interviews for thematic analysis, using an inductive approach to generate the study’s findings. Findings: Several themes emerged around perceived barriers and facilitators to care. Providers cited patient beliefs and behaviors, driven in part by cultural norms, as key challenges to hypertension control; however, most felt their own approach to hypertension treatment aligned with international guidelines. Providers struggled to collaborate with colleagues in coordinating the joint management of patients. Furthermore, they cited the high cost and limited availability of medication as barriers. Conclusions: These findings offer important strategic direction for intervention development specific to this Ugandan context: for example, regarding culturally-adapted patient education initiatives, or programs to improve access to essential medications. Other settings facing similar challenges scaling up management of hypertension may find the results useful for informing intervention development as well.
format	article
author	Aliza S. Green Hayley M. Lynch Rose Clarke Nanyonga Allison P. Squires Darinka D. Gadikota-Klumpers Jeremy I. Schwartz David J. Heller
author_facet	Aliza S. Green Hayley M. Lynch Rose Clarke Nanyonga Allison P. Squires Darinka D. Gadikota-Klumpers Jeremy I. Schwartz David J. Heller
author_sort	Aliza S. Green
title	Assessing Providers’ Approach to Hypertension Management at a Large, Private Hospital in Kampala, Uganda
title_short	Assessing Providers’ Approach to Hypertension Management at a Large, Private Hospital in Kampala, Uganda
title_full	Assessing Providers’ Approach to Hypertension Management at a Large, Private Hospital in Kampala, Uganda
title_fullStr	Assessing Providers’ Approach to Hypertension Management at a Large, Private Hospital in Kampala, Uganda
title_full_unstemmed	Assessing Providers’ Approach to Hypertension Management at a Large, Private Hospital in Kampala, Uganda
title_sort	assessing providers’ approach to hypertension management at a large, private hospital in kampala, uganda
publisher	Ubiquity Press
publishDate	2020
url	https://doaj.org/article/df9d4f31485749c1a9a2a8e443b573bf
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Assessing Providers’ Approach to Hypertension Management at a Large, Private Hospital in Kampala, Uganda

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