Please use this identifier to cite or link to this item:
Title: Health system challenges to hypertension and related non-communicable diseases prevention and treatment: Perspectives from Ghanaian stakeholders
Authors: Laar, A.K.
Adler, A.J.
Kotoh, A.M.
Legido-Quigley, H. 
Lange, I.L.
Perel, P.
Lamptey, P.
Keywords: Challenges
Hypertension prevention and treatment
Non-communicable diseases
Issue Date: 2019
Publisher: BioMed Central Ltd.
Citation: Laar, A.K., Adler, A.J., Kotoh, A.M., Legido-Quigley, H., Lange, I.L., Perel, P., Lamptey, P. (2019). Health system challenges to hypertension and related non-communicable diseases prevention and treatment: Perspectives from Ghanaian stakeholders. BMC Health Services Research 19 (1) : 693. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
Abstract: Background: Hypertension, itself a cardiovascular condition, is a significant risk factor for other cardiovascular diseases. Hypertension is recognized as a major public health challenge in Ghana. Beginning in 2014, a collaborative team launched the community-based hypertension improvement program (ComHIP) in one health district in Ghana. The ComHIP project, a public-private partnership, tests a community-based model that engages the private sector and utilizes information and communication technology (ICT) to control hypertension. This paper, focuses on the various challenges associated with managing hypertension in Ghana, as reported by ComHIP stakeholders. Methods: A total of 55 informants-comprising patients, health care professionals, licensed chemical sellers (LCS), national and sub-national policymakers-were purposively selected for interview and focus group discussions (FGDs). Interviews were audio-recorded and transcribed verbatim. Where applicable, transcriptions were translated directly from local language to English. The data were then analysed using two-step thematic analysis. The protocol was approved by the two ethics review committees based in Ghana and the third, based in the United Kingdom. All participants were interviewed after giving informed consent. Results: Our data have implications for the on-going implementation of ComHIP, especially the importance of policy maker buy-in, and the benefits, as well as drawbacks, of the program to different stakeholders. While our data show that the ComHIP initiative is acceptable to patients and healthcare providers-increasing providers' knowledge on hypertension and patients' awareness of same-there were implementation challenges identified by both patients and providers. Policy level challenges relate to task-sharing bottlenecks, which precluded nurses from prescribing or dispensing antihypertensives, and LCS from stocking same. Medication adherence and the phenomenon of medical pluralism in Ghana were identified challenges. The perspectives from the national level stakeholders enable elucidation of whole of health system challenges to ComHIP and similarly designed programmes. Conclusions: This paper sheds important light on the patient/individual, and system level challenges to hypertension and related non-communicable disease prevention and treatment in Ghana. The data show that although the ComHIP initiative is acceptable to patients and healthcare providers, policy level task-sharing bottlenecks preclude optimal implementation of ComHIP. � 2019 The Author(s).
Source Title: BMC Health Services Research
ISSN: 14726963
DOI: 10.1186/s12913-019-4571-6
Rights: Attribution 4.0 International
Appears in Collections:Staff Publications

Show full item record
Files in This Item:
File Description SizeFormatAccess SettingsVersion 
10_1186_s12913-019-4571-6.pdf607.99 kBAdobe PDF



Google ScholarTM



This item is licensed under a Creative Commons License Creative Commons