Adapting a nurse-led primary care initiative to cardiovascular disease control in Ghana: a qualitative study
Autor: | Denis Awuni, Leah A. Haykin, Raymond A. Aborigo, Aurelia Abapali, Edith Dambayi, Elliasu Yakubu, Jordan A. Francke, David J. Heller, Elizabeth F. Jackson, Abraham Oduro, James F. Phillips, Engelbert A. Nonterah, Ayaga A. Bawah |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Adult
Male Rural Population medicine.medical_specialty Community education Referral education Psychological intervention Alcohol abuse Health Promotion 030204 cardiovascular system & hematology Nurse's Role Ghana 03 medical and health sciences 0302 clinical medicine Patient Education as Topic medicine Humans 030212 general & internal medicine Qualitative Research Aged Aged 80 and over Primary Health Care business.industry Public health lcsh:Public aspects of medicine Public Health Environmental and Occupational Health lcsh:RA1-1270 Middle Aged medicine.disease Cardiovascular disease Outreach Cardiovascular Diseases Family medicine Community health Female Rural Health Services business Delivery of Health Care Qualitative research Research Article |
Zdroj: | BMC Public Health, Vol 20, Iss 1, Pp 1-12 (2020) BMC Public Health |
ISSN: | 1471-2458 |
Popis: | Background CVD is the leading cause of morbidity and mortality worldwide, and its prevalence is rising in Ghana. The Community-Based Health Planning and Services (CHPS) initiative has used community-level clinics, home visits by nurses, and outreach services to decrease maternal and child mortality across Ghana. However, CHPS currently lacks capacity to screen for or treat CVD and its risk factors. Methods We conducted in-depth interviews (IDIs) with 21 nurse community health officers (CHOs) and 10 supervising sub-district leaders (SDLs) to identify factors that constrain or facilitate CHPS screening and treatment for CVD through the World Health Organization’s HEARTS protocol in the rural communities of the Kassena-Nankana East and West districts of Ghana. We transcribed audio recordings of the interviews, coded their content, and analyzed codes for key themes. Results Respondents spoke to CVD care barriers across three themes: community demand for CVD care; community access to CVD care; and provider capacity to render CVD care. CHOs and SDLs noted that community members were often unaware of CVD, despite high reported local prevalence of risk factors such as alcohol use and stress. Moreover, community members were unable to travel to or pay for treatment once diagnosed. CHOs lacked training on CVD and its risk factors, as well as medications and supplies to treat conditions such as high blood pressure. However, CHOs and SDLs recognized the importance of CVD care, expressed interest in acquiring further training, and emphasized the need to improve logistical support for primary care as a precondition for CVD care. Conclusion Nurses and supervisors associated with the CHPS program voiced multiple obstacles to CVD care, but also listed several feasible steps to address them. Initiatives such as CVD-focused training; provision of essential CVD equipment and pharmaceuticals; community education campaigns; and transportation to aid patients and providers could address these barriers. Future work will explore the feasibility and acceptability of these interventions among staff and community members, in preparation for a locally adapted pilot initiative drawing from the HEARTS initiative designed to control CVD risk factors such as hypertension, depression, and alcohol abuse. |
Databáze: | OpenAIRE |
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