The University of Southampton
University of Southampton Institutional Repository

Managing hypertension in nurse-led primary care clinics in rural Ethiopia

Managing hypertension in nurse-led primary care clinics in rural Ethiopia
Managing hypertension in nurse-led primary care clinics in rural Ethiopia

Background: Providing health care for patients with hypertension has been difficult in rural areas of sub-Saharan Africa because of lack of medical staff and facilities. The use of non-physician healthcare workers offers a possible solution, but little is known about the feasibility and clinical response to treatment. Methods: We carried out a descriptive, retrospective review of the records of a sequential sample of 249 hypertensive patients aged 52.3 (SD 12.7) years from eight health centres in a rural area of southern Ethiopia where nurses and health officers had been previously trained to diagnose, treat and manage non-communicable diseases including hypertension. The study evaluated the changes in systolic and diastolic blood pressures following treatment over a 30 month period. Results: The mean systolic blood pressure on admission was 156.1(SD 21.1) mm Hg and the mean diastolic pressure 95.7(SD 12.7) mm Hg. Of the 249 subjects, 105(42.1%) defaulted from clinic follow-up during the period of the study. More than half (53.8%) were controlled on monotherapy with a thiazide diuretic, the remainder required combination therapy. Significant declines in systolic and diastolic blood pressure were achieved in each blood pressure group with the exception of the lowest pressure groups. Conclusion: Our study demonstrates that nurses and heath officers working in remote rural health centres can obtain worthwhile reductions in blood pressure in patients with hypertension. Moreover, this could often be achieved with a single, inexpensive diuretic, hydrochlorthiazide, although combination therapy was sometimes required.

Blood pressure, Delivery of health care, Ethiopia, Hypertension, Nurses, Task-shifting
1021-6790
104-109
Shanko, Kebubush
5c4cce63-20bd-4a36-bd38-2a4928b87462
Balcha, Fikadu
f5e272d9-21c2-4e67-a1b8-69c570a0d9ea
Parry, Eldryd
5ad2e205-595f-43f4-be05-446267c7ce4e
Mortimore, Andrew
6d0c7524-175a-4396-b1a4-f6cd1aabee00
Osmond, Clive
2677bf85-494f-4a78-adf8-580e1b8acb81
Phillips, David I.W.
29b73be7-2ff9-4fff-ae42-d59842df4cc6
Mamo, Yoseph
54890fc0-664b-4ad0-b820-660c18854390
Shanko, Kebubush
5c4cce63-20bd-4a36-bd38-2a4928b87462
Balcha, Fikadu
f5e272d9-21c2-4e67-a1b8-69c570a0d9ea
Parry, Eldryd
5ad2e205-595f-43f4-be05-446267c7ce4e
Mortimore, Andrew
6d0c7524-175a-4396-b1a4-f6cd1aabee00
Osmond, Clive
2677bf85-494f-4a78-adf8-580e1b8acb81
Phillips, David I.W.
29b73be7-2ff9-4fff-ae42-d59842df4cc6
Mamo, Yoseph
54890fc0-664b-4ad0-b820-660c18854390

Shanko, Kebubush, Balcha, Fikadu, Parry, Eldryd, Mortimore, Andrew, Osmond, Clive, Phillips, David I.W. and Mamo, Yoseph (2018) Managing hypertension in nurse-led primary care clinics in rural Ethiopia. Ethiopian Journal of Health Development, 32 (2), 104-109.

Record type: Article

Abstract

Background: Providing health care for patients with hypertension has been difficult in rural areas of sub-Saharan Africa because of lack of medical staff and facilities. The use of non-physician healthcare workers offers a possible solution, but little is known about the feasibility and clinical response to treatment. Methods: We carried out a descriptive, retrospective review of the records of a sequential sample of 249 hypertensive patients aged 52.3 (SD 12.7) years from eight health centres in a rural area of southern Ethiopia where nurses and health officers had been previously trained to diagnose, treat and manage non-communicable diseases including hypertension. The study evaluated the changes in systolic and diastolic blood pressures following treatment over a 30 month period. Results: The mean systolic blood pressure on admission was 156.1(SD 21.1) mm Hg and the mean diastolic pressure 95.7(SD 12.7) mm Hg. Of the 249 subjects, 105(42.1%) defaulted from clinic follow-up during the period of the study. More than half (53.8%) were controlled on monotherapy with a thiazide diuretic, the remainder required combination therapy. Significant declines in systolic and diastolic blood pressure were achieved in each blood pressure group with the exception of the lowest pressure groups. Conclusion: Our study demonstrates that nurses and heath officers working in remote rural health centres can obtain worthwhile reductions in blood pressure in patients with hypertension. Moreover, this could often be achieved with a single, inexpensive diuretic, hydrochlorthiazide, although combination therapy was sometimes required.

Text
Shenkopaper - Accepted Manuscript
Restricted to Registered users only
Download (461kB)
Request a copy

More information

e-pub ahead of print date: 20 July 2018
Keywords: Blood pressure, Delivery of health care, Ethiopia, Hypertension, Nurses, Task-shifting

Identifiers

Local EPrints ID: 425598
URI: https://eprints.soton.ac.uk/id/eprint/425598
ISSN: 1021-6790
PURE UUID: 77035cf4-1cd0-40a8-b8b8-d2b922760e05
ORCID for Clive Osmond: ORCID iD orcid.org/0000-0002-9054-4655

Catalogue record

Date deposited: 25 Oct 2018 16:30
Last modified: 20 Jul 2019 01:18

Export record

Contributors

Author: Kebubush Shanko
Author: Fikadu Balcha
Author: Eldryd Parry
Author: Andrew Mortimore
Author: Clive Osmond ORCID iD
Author: David I.W. Phillips
Author: Yoseph Mamo

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×