The magnitude of hypertension screening implementation and its challenge by health professionals in South Gondar zone public health centers, 2023; Mixed Method

Abstract

Background: Hypertension is the most prevalent cardiovascular disorder in the world and according to the WHO, it affects 1.28 billion adults aged 30 –79 years worldwide, two-thirds living in low-income and middle-income countries. The Ethiopian Ministry of Health recommends that all adults check their blood pressure. However, there is a wide gap between evidence-based recommendations and current practice. This study aimed to assess the magnitude of hypertension screening implementation and its challenge by health professionals in South Gondar zone public health centers, in Northwest Ethiopia. Methods: A mixed approach with a facility-based cross-sectional study and phenomenological study design was conducted concurrently in South Gondar public health centers, in Ethiopia from Oct 2023 to Jan 2024. About 416 health professionals and 12 key informants were enrolled in the study. Simple random sampling technique and purposive sampling were employed to select study participants. A structured questionnaire, observation, and semi-structured interview guide tool were used to collect the data. A multi variable logistic regression analysis was employed and variables with P-value of ˂= 0.05 were considered as statistically significant risk factors. The thematic analysis was used for the qualitative data using open code 4.02 software. Results: In this study 416 participant were involved with a response rate of 98.6%. About 147 (35% at 95% CI: 30.9,40.0) of health professionals were implemented hypertension screening. Work experience (5 to 9 years) (AOR = 4.16; 95% CI: 1.35,12.8); ≥ 15 years (AOR = 17; 95% CI: 2.31,125.3); and knowledge about hypertension screening (moderate knowledge (AOR = 2.47 at 95% CI: 1.15,5.35)) and high knowledge (AOR = 32 at 95% CI: 11.26,93.14) were identified as significant attributes for the implementation of HTN screening. Whereas lack of HTN screening guidelines (AOR = 0.16; 95% CI: 0.07,0.47), lack of registration books (AOR = 0.24; 95% CI: 0.07,0.75), lack of functional BP apparatus (AOR = 0.09; 95% CI: 0.04,0.19), and lack of BP apparatus (AOR = 0.12 at 95% CI: 0.05,0.39) emerged as statistically significant factors impeding implementation of hypertension screening. Conclusion and recommendation: The magnitude of hypertension screening implementation by healthcare providers was low in health centers. Work experience, availability of registers, availability of BP apparatus, guidelines for hypertension screening, functional BP apparatus for hypertension screening, and knowledge about hypertension screening were factors significantly affecting the implementation of hypertension screening by healthcare providers. Primary healthcare facilities and the Ministry of Health should emphasize the importance of hypertension screening to health workers, provide screening registers and equipment, offer regular screening training, and improve staffing levels at these facilities.