Hypertension service delivery capacity assessment in Malawi: Results from Malawi longitudinal study of families and health in Balaka, Machinga, Mchinji and Rumphi health care facilities
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Date
2020-12-31
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Kamuzu University of Health Sciences
Abstract
Management of hypertension has challenges due to different factors. These include
unavailability of drugs, poor infrastructure, inexperienced personnel, insufficient diagnostic
tools, and high treatment costs. Malawi adopted a Package for Essential Non-communicable
(PEN) and was incorporated in Malawi Standard Treatment Guidelines (MSTG) for the
management of various diseases including hypertension in 2015. Since the inception of the
MSTG, the service delivery capacity for hypertension care in some health care facilities has
not been well researched. We conducted this cross-sectional study to assess health service
capacity to deliver comprehensive hypertension care. Data were extracted from the parent
study of Health Care Facility questionnaire of the Malawi Longitudinal Study of Families
Health. Descriptive statistics were analyzed using Stata version 14. Of the facilities
managers’ qualifications, 53.6% or they were Medical Assistants and 45.8% of them had 2
years of post-secondary education. Most of the managers 82.1% did not have in-service
training or update on topics specific to the diagnosis and/or management of hypertension. In
57.1% of the facilities, copies of protocols and guidelines for the or management of
hypertension were not available. Aspirin was the most available drug (89.3%) and Calcium
Channel Blockers were not available in 69.7% of the health care facilities. We have found
gaps in health facilities capacity to deliver comprehensive hypertension care. Future
interventions should aim in targeting the highlighted gaps to improve capacity.