Service availability, and readiness of primary care health facilities to offer hypertension diagnosis services in Wakiso District

Abstract

Background: Despite the existing knowledge about the growing hypertension epidemic, few people are receiving appropriate diagnosis services in health facilities in low-income countries like Uganda. Information on the services available, and the health-facility readiness to offer hypertension diagnosis services is still scanty. In addition, the health-facility facilitators and barriers to the provision of hypertension diagnosis services in Wakiso district are unknown. The study assessed service availability, and readiness of the primary care health facilities in offering hypertension diagnosis services. Methods: A cross sectional study design was used, 79 health facilities at Health Centre (HC) II, HCIII, HCIV and Hospital levels were sampled randomly. Health-facility checklists were administered to the health facility in-charges, individual semi-structured questionnaires to health workers and key informant interview guides to a purposive sample of health workers and personnel at Wakiso district. Chi-square and the Fisher’s exact test were used to assess associations between categorical variables. Service availability was measured by assessing the provision of blood pressure (BP) measurements, weight measurements and the scheduling of regular check-ups. Readiness was measured by assessing the availability and functional status of the BP apparatus, other hypertension diagnostic equipment and supplies, and yet also the presence of a trained health care provider. Results: The majority (86%) of the primary care health facilities offered all the hypertension diagnosis services and 13% of the HCII were ready to offer comprehensive hypertension diagnosis services. There were significant associations between the level of the health facility; BP measurements (P=0.005), managing newly diagnosed cases of hypertension (P=0.001), and scheduling of regular check-ups (P=0.003). The health workers were facilitated by the availability of equipment, primary health care funds and implementing partners, whereas the barriers faced were the availability of non-functional equipment, delays in receiving trainings and inadequate staffing. Conclusion: The study showed that the majority of the primary care health facilities offered hypertension diagnosis services including the HCIIs which are lowest in the tier. There were gaps in the readiness to offer hypertension diagnosis services, thus equipment should be routinely calibrated, replaced and routine continuous medical education sessions should be provided to the health workers.