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Charles Musoke, MBChB, MMed

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GHES LMIC Fellow 2019-2020

FELLOWSHIP SITE: Uganda Initiative for Integrated Management of Non-Communicable Diseases
U.S. INSTITUTION: Yale University

Project Title: A MIXED METHODS STUDY OF BARRIERS AND ENABLERS TO BLOOD PRESSURE CONTROL IN TWO PRIMARY HEALTH CARE FACILITIES IN KAMPALA, UGANDA

Hypertension (HTN) is the most common cardiovascular disorder, affecting nearly one billion people globally. More than half of those affected are found in low- and middle-income countries. Uncontrolled blood pressure is the primary independent risk factor for stroke, coronary artery disease, heart failure and chronic kidney disease. In Uganda, the 2014 nationally representative household NCD survey found the prevalence of HTN at 26.4% while the levels of awareness, treatment and control stand at 28.2%, 51.6% and 9.4%, respectively. These low levels of awareness and control are reflected in our daily clinical practice were we care for patients presenting with complications of untreated or undertreated HTN. We propose to assess for such barriers and facilitators in two representative lower level public sector primary care clinics managed by the Kampala Capital City Authority (KCCA) using an exploratory sequential mixed methods design.

 Study objectives:

  1. Explore patient level HTN self-care behaviours that affect blood pressure control including awareness and understanding of diagnosis, adoption of lifestyle management and their perceptions about medications and side effects.

  2. Explore provider-level factors that may impact blood pressure control among hypertensive patients at the KCCA clinic.

  3. Assess knowledge, attitudes, and practices of self-care for HTN among patients with HTN at two public sector health clinics in Kampala.

Data collection

For objective one we shall conduct Focus group discussions with hypertensive patients. Key informant interviews will be conducted to answer the second objective. For objective three, themes from the qualitative data analysis will be used to inform the development of a survey instrument. This will then be applied to a random sample of patients with HTN (both controlled and uncontrolled) to determine factors that impact blood pressure control in this setting.