[PP.01.04] HEALTHY HEART AFRICA IN KENYA: EVALUATION OF PROGRAM IMPACT ON HEALTHCARE PROVIDERS' KNOWLEDGE AND PROVISION OF CARE FOR HYPERTENSION. (September 2017)

• Record Type: Journal Article
• Authors: Yonga, G.; Jimenez, J.; Okello, F.O.; Macgregor-Skinner, E.; Herr, J.; Ogola, E.N.
• Is Part Of: Journal of hypertension. Volume 35(2017)Supplement 2
• Publication Date: 2017-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000523217.80744.72
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Despite increased hypertension (HTN) prevalence in Africa, awareness, detection, and treatment remains universally low. The Healthy Heart Africa (HHA) program was developed with the goal of sustainably addressing multiple barriers to HTN care, including educating healthcare providers (HCPs) on HTN management/treatment. Here, we evaluate the impact of HHA on HCP knowledge and practice in Kenya over 12 months. Design and method: HHA collaborated with local Kenyan organizations to develop/update HTN guidelines; provide training, equipment, and educational materials; and improve treatment availability. Among facilities chosen for inclusion, the evaluation used a sample of intervention facilities selected using stratified random sampling; matched comparison facilities were selected based on the implementing partner, location, and facility type. Facilities were surveyed at baseline and 12 months later. A difference-in-differences analysis was used to assess program effects by comparing outcomes from intervention and control facilities. HTN screening/treatment data were supplemental and abstracted from service delivery registers. Results: The analysis included 66 intervention and 66 control facilities, consisting of dispensaries/clinics (55.9% and 67.2%, respectively), health centers (24.0% and 20.8%), and district/subdistrict hospitals (20.1% and 12.1%) (P = not significant for intervention vs control). At baseline, both groups did not differ significantly regarding HCP staffing and availability of basic healthcare equipment, including blood pressure (BP) machines. HHA improved HCPs knowledge of > = 5 HTN risk factors and > = 5 methods for reducing/managing HTN (P < 0.05 vs control for all; Table). Knowledge of high/severe BP thresholds and the number of new HTN patients increased at intervention and control facilities but did not significantly differ between groups. Intervention versus control facilities were more likely to measure BP > 1 time in the same visit to diagnose HTN (P < 0.05), have days dedicated to HTN care (P < 0.05), use posters to increase HTN awareness (P < 0.01), and have increased access to hydrochlorothiazide (P < 0.05). Access to amlodipine and enalapril increased, but statistical significance was not achieved. Figure. No caption available. Conclusions: Over 12 months, the HHA program in Kenya positively affected HCP knowledge of HTN risk factors and management, improved screening practices and awareness to detect HTN, and increased access to guideline-recommended HTN medication.