Abstract 18503: Barriers to Linkage to Hypertension Care in Rural Western Kenya: A Qualitative Analysis
Introduction: Hypertension is the leading global risk factor for mortality and its prevalence is rising in sub-Saharan Africa (SSA). Unless adequately controlled, hypertension will impose large health and economic burdens. Since delays in seeking hypertension care are associated with increased mortality, a critical component of hypertension control is to facilitate early and sustained access of affected individuals to clinical services. However, specific barriers to linkage to hypertension care in SSA are not known.
Objective: To evaluate barriers to linkage to hypertension care in rural western Kenya, using a qualitative research approach.
Methods: Six mabaraza, or community gatherings (123 men, 119 women), and 17 focus group discussions (88 men, 81 women) were conducted among community health workers, community members, and hypertensive patients, across a spectrum of age, sex, occupation, and distance from health facility. Content analysis was performed with NVivo 10, identifying key themes representing distinct barriers, which were then classified into a modified Health Belief Model. Ranking of identified barriers was performed using triangulation of participant response density, Delphi method of investigator assessments, and published literature.
Results: The salient barriers and corresponding proposed solutions are summarized in the Table. Cognitive issues related to knowledge of hypertension and its risks and management were commonly reported by participants. Emotional elements, particularly HIV stigma and fear, were highlighted. Environmental barriers such as finances, distance, and quality of service also featured prominently.
Conclusion: Linkage to hypertension care is a critical component to a successful hypertension care delivery program. However, successful execution is contingent upon addressing potential barriers at the cognitive, emotional, and environmental levels.
- © 2013 by American Heart Association, Inc.