Key result
CHW-facilitated telehealth achieves high patient and provider satisfaction for community-based hypertension care.
Why the study?
Hypertension is a growing concern in sub-Saharan Africa with challenging care access in rural areas, making the evaluation of community health worker and telehealth care models a priority.
Does CHW-facilitated telehealth provide an acceptable and satisfactory model for hypertension care in rural adults compared to clinic-based care?
Does CHW-facilitated telehealth provide an acceptable and satisfactory model for hypertension care in rural adults compared to clinic-based care?
CHW-facilitated telehealth is a highly acceptable, patient-centered model for hypertension management in rural African settings that overcomes transportation barriers.
High satisfaction supports CHW-telehealth adoption to cut transport barriers in rural hypertension care; extends qualitative RCT evidence on acceptability.
Introduction Hypertension is a growing health concern in sub-Saharan Africa, yet access to care can be challenging, especially in rural areas. Overcoming barriers to hypertension care remains a priority. Pairing community health worker (CHW) and telehealth modalities offers one way to extend the reach of hypertension care without overburdening patients or healthcare systems in rural areas. Methods This qualitative study was nested within the SEARCH Sapphire pilot randomised controlled trial testing hypertension treatment through CHW-facilitated, clinician-driven telehealth (intervention) compared to clinic-based care (control) for adults aged ≥40 years with moderate-severe hypertension in rural western Kenya and southwestern Uganda. We conducted audio-recorded, in-depth, semi-structured interviews with purposively selected healthcare providers (clinicians and CHWs; N = 15) and participants (N = 40) between January-April 2023 to explore hypertension diagnosis and linkage to care; experiences with community hypertension care; family and work contexts; and the integration of telehealth into clinic and CHW workflows. Results Overall, participants felt satisfied with community-delivered telehealth care for hypertension. Participants noted community-based care saved on transport costs and reached those who were unwell or who lived far from clinic. Intervention arm participants felt CHWs were suitable for routine hypertension care, worked closely with clinicians, and could increase health literacy within the community. Participants desired a model with clear communication and involvement of the facility-based clinician, CHW, and participant. Providers found telehealth to be of similar quality to clinic-based care for routine hypertension treatment, though noted that clinic-based care is at times needed for more comprehensive clinical evaluation or to provide additional healthcare services. Conclusions Participants and providers indicated overall positive attitudes and receptivity to CHW-facilitated telehealth for hypertension care. CHW-delivered telehealth for community-based hypertension care offers one way to improve hypertension treatment outcomes in a manner that prioritizes patient-centeredness and maintains care quality. Trial Registration NCT04810650 Registered on 2021-03-18.
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Johnson‐Peretz et al. (2026) studied Moderate-to-severe hypertension (n=55). CHW-facilitated, clinician-driven telehealth vs. Clinic-based care was evaluated on Patient and provider perceptions, experiences, and preferences regarding community-based telehealth versus clinic-based hypertension care. Participants and providers expressed overall positive attitudes and high satisfaction with CHW-facilitated telehealth for community-based hypertension care, noting it saved transport costs and maintained care quality.
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