PREPAREDNESS OF PRIMARY HEALTHCARE FACILITIES IN THE MANAGEMENT OF HYPERTENSION IN THARAKA NITHI COUNTY, KENYA

Abstract

Hypertension is a leading contributor to the global burden of non-communicable disease (NCD). The effective management of hypertension is an urgent need in developing countries, where its prevalence is on the rise. To this end, the preparedness of primary healthcare facilities in Tharaka Nithi County, Kenya, towards managing hypertension was evaluated in the current study. The study aimed to determine the proportion of primary healthcare facilities utilizing hypertension management guidelines, examine the availability of functional equipment for blood pressure measurement in primary healthcare facilities, determine the staffing composition in primary healthcare facilities, and assess the availability of essential medicines for the management of hypertension. The study involved 93 health care facilities which were sampled using a multi-stage sampling technique. Data was collected using the modified World Health Organization (WHO) Service Availability and Readiness Assessment (SARA) questionnaire. The collected data was analyzed using the Statistical Package of Social Sciences (SPSS) version 27 for both descriptive statistics (mean, mode, percentages, and standard deviation) and inferential statistics (Chi- square, ANOVA, and regression). Findings were displayed in the form of tables and graphs. In the study, all ethical considerations were considered. The majority (64.5%, n=60) of health facilities reported unsatisfactory utilization of guidelines in the management of hypertension. Only, 26.9% (n=25) had adequate equipment that were functional and whose efficiency was supervised. Approximately 62.4% (n=58) of the health facilities had satisfactory staffing composition. For essential medicine availability, 73.1% (n=68) had satisfactory availability. Statistically significant differences were also noted in guideline utilization (OR=0.319, C.I, 0.104-0.975; p- value = 0.035), equipment availability(OR=6.650, C.I, 1.377-32.114; p-value = 0.018), staffing composition (OR=4.343, C.I, 1.535-12.289; pvalue = 0.006) and availability of essential medicine (OR=3.598, C.I, 1.087-11.911; pvalue = 0.036) based on the type of health facilities (dispensary, health centers, and Private medical clinics). The findings suggest a lack of preparedness as evidenced by the numerous barriers towards hypertension diagnosis and management in Tharaka Nithi County primary health facilities. There is an urgent need to develop new strategies, policies, and programs that will promote the preparedness of healthcare facilities for the prevention and control of hypertension. Provision and promotion of hypertension guidelines usage in all primary health care facilities is strongly recommended. Adequate staffing, training of healthcare workers, and the supply of essential medicines for the management of hypertension are key to the improvement of hypertension control