Key result
Targeted primary care training boosts NCD knowledge ~26%, but clinical practice gains decline by 3 months.
Why the study?
Does a targeted training intervention improve knowledge and clinical care practices for diabetes and hypertension management among primary healthcare workers?
Does a targeted training intervention improve knowledge and clinical care practices for diabetes and hypertension management among primary healthcare workers?
Absolute Event Rate: 8.17% vs 6.46%
p-value: p=0.0002
Targeted training for primary healthcare workers improves short-term knowledge and clinical practices for diabetes and hypertension management, but sustained behavior change requires complementary systemic interventions.
BACKGROUND: Strengthening primary healthcare (PHC) worker’s clinical capacity remains critical for improving non-communicable disease (NCD) outcomes in low-resource settings. This study evaluated a targeted training for PHC workers in Kisumu County, Kenya, focusing on diabetes and hypertension management. The aim of the study was to evaluate a training intervention by assessing its relevance, acceptability, and feasibility, as well as its initial effects on both knowledge and clinical care practices in diabetes and hypertension management. METHODS: A mixed-methods design was used, involving 24 purposively selected PHC workers from 10 PHC facilities. Quantitative data were collected at three time points: pre-training, post-training, and three months later using structured questionnaires and observation checklists to assess changes in NCD knowledge and clinical care practices. Qualitative data from focus group discussions explored perceptions of PHC workers, barriers, and facilitators to implementation. Statistical analyses included paired-t-tests, McNemar’s test, and Wilcoxon signed-rank test while qualitative data were analyzed thematically using Dedoose software. RESULTS: The training intervention received high acceptability ratings, with a mean score of 4.80 out of 5. NCD knowledge significantly improved post-training (mean score: 6.46 to 8.17, p = 0.0002), a 26% increase and was largely retained at the three-month follow-up. Clinical care practices also improved initially (mean score: 3.17 to 4.29, p = 0.0032), but declined at follow-up (mean score: 3.71, p = 0.0284), reflecting challenges in sustaining behavior change. Observational data and qualitative findings revealed systemic barriers such as inadequate resources and weak technical support that hindered consistent application of the learned practices. CONCLUSIONS: While the training intervention effectively improved PHC workers’ knowledge on DM and HTN management and short-term clinical practices, sustained improvements in care delivery require complementary systemic interventions. These include strengthening facility readiness, supply chains, and ongoing mentorship to support the translation of knowledge into routine clinical practice.
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Ouma et al. (2026) studied Diabetes and hypertension (n=24). Targeted training for diabetes and hypertension management vs. Pre-training baseline was evaluated on NCD knowledge score (p=0.0002). Targeted training for primary healthcare workers significantly improved NCD knowledge scores from 6.46 to 8.17 (p=0.0002), though initial clinical practice improvements declined at 3 months.
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