Assessment of hypertension service availability in some primary health centres in Nigeria: a mixed-methods study.

Autor:	Adejumo O; Department of Internal Medicine, University of Medical Sciences, Ondo City, Ondo State, Nigeria oaadejumo@unimed.edu.ng., Ogundele O; Department of Community Medicine, University of Medical Sciences, Ondo, Nigeria., Mamven M; Department of Internal Medicine, University of Abuja, Gwagwalada, Federal Capital Territory, Nigeria., Oyedepo D; Department of Internal Medicine, University of Ilorin Teaching Hospital, Ilorin, Kwara, Nigeria., Ntaji M; Department of Community Medicine, Delta State University, Abraka, Nigeria., Mohammed A; Department of Internal Medicine, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Bauchi, Nigeria., Bello Lawal AT; Department of Internal Medicine, Federal Medical Centre, Birnin Kebbi, Kebbi State, Nigeria., Onyebuchi OS; Department of Internal Medicine, Federal University Teaching Hospital, Owerri, Imo State, Nigeria., Akakuru OK; Department of Logistics and Essential Drugs, Primary Health Care Development Agency, Owerri, Imo State, Nigeria., Lawal OM; Department of Internal Medicine, University of Medical Sciences, Ondo City, Ondo State, Nigeria., Akinbodewa AA; Department of Internal Medicine, University of Medical Sciences, Ondo City, Ondo State, Nigeria., Akinbode AO; Department of Family Medicine, Federal Medical Centre, Birnin Keffi, Keffi State, Nigeria., Enikuomehin AC; Department of Internal Medicine, University of Medical Sciences, Ondo City, Ondo State, Nigeria., Ngoka S; Department of Internal Medicine, Federal University Teaching Hospital, Owerri, Imo State, Nigeria., Lade-Ige TS; Department of Internal Medicine, University of Medical Sciences, Ondo City, Ondo State, Nigeria.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2023 Aug 08; Vol. 13 (8), pp. e073833. Date of Electronic Publication: 2023 Aug 08.
DOI:	10.1136/bmjopen-2023-073833
Abstrakt:	Objective: Strengthening primary health centre (PHC) systems is a potentially effective strategy to reduce the burden of non-communicable diseases in Nigeria, a low/middle-income country with limited resources. The aim of this study was to assess hypertension service availability in some PHCs in Nigeria and seek recommendations that could facilitate improved services from PHC workers. Design: Explanatory sequential mixed-methods study. Settings: PHCs in the six geopolitical zones and Federal Capital City of Nigeria. Participants: Eighteen PHC workers and 305 PHC facilities. Method: Hypertension service availability and readiness were assessed in PHCs across Nigeria using a pro forma adapted from the WHO Service Readiness and Assessment tool. Eighteen workers in the PHCs were subsequently interviewed for in-depth exploration of hypertension service availability and readiness. Findings: Among the 305 health facilities assessed, 96 (31.5%) were in urban, 94 (30.8%) in semiurban and 115 (37.7%) in rural local government areas. Majority of the health facilities (43.0%) were manned by community extension workers. Only 1.6% and 19.7% of the health facilities had physicians and pharmacy technicians, respectively. About 22.3% of the providers had training in hypertension in the last 1 year. All the PHCs lacked adequate supply of essential antihypertensive medications. The identified deficiencies were less common in the urban PHCs compared with others. Qualitative analysis showed that the personnel, essential facilities and medicines required to provide hypertension services in the PHCs were inadequate. Suggested recommendations to successfully provide these services were provision of performance-based incentives; adequate staffing and training; supportive supervision of staff; provision of adequate equipment and essential medicines for hypertension management; provision of conducive environment for clients; and community engagement and participation. Conclusion: Majority of the PHCs are currently not adequately equipped to provide hypertension services. Addressing identified gaps and using suggestions provided will guarantee successful provision of effective services. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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