Why the study?
Ethiopia has been piloting a primary healthcare hypertension program to improve hypertension control, but its effectiveness had not yet been ascertained.
Does a pilot hypertension program improve hypertension screening, detection, and control in primary healthcare settings?
Does a pilot hypertension program improve hypertension screening, detection, and control in primary healthcare settings?
A pilot hypertension program in Ethiopian primary healthcare settings significantly improved blood pressure screening, detection, and control rates.
Pilot facilities had higher screening, detection, and control rates; hypothesis-generating for scale-up pending randomized trials.
Problems considered To improve hypertension control, Ethiopia has been piloting a hypertension program in primary healthcare settings whose effectiveness has not yet been ascertained. This study aimed to determine the effectiveness of a pilot hypertension program in hypertension prevention, treatment and control in the Amhara region of Ethiopia. Methods A parallel evaluation design guided by the CDC's Framework for Public Health Program Evaluation was conducted at four pilot and four non-pilot health facilities in Ethiopia's Amhara region. Data were collected using a checklist and a structured questionnaire. Data were analyzed using SPSS version 25.0. Statistical comparisons were made using chi-square tests, t-tests, 95% confidence intervals, and p < 0.05. Results Opportunistic blood pressure (BP) screening was significantly higher in pilot facilities (91%, 95% CI: 87.8–93.5%) than in non-pilot facilities (74.4%, 95% CI: 71.2–79.7%). Hypertension detection rates were also significantly higher in pilot facilities (19.9%, 95% CI: 16.2–24.0%) compared to non-pilot facilities (14.9%, 95% CI: 11.7–18.6%). BP control was achieved in 51.8% of patients in pilot and 42.4% in non-pilot facilities (χ 2 = 10.823; p < 0.001). The mean performance across the three domains was higher in pilot facilities (76.1%) compared to non-pilot facilities (51.2%) (t = 2.125; p=0.042) Conclusion The pilot program in the Amhara region showed promising results in hypertension prevention, treatment, and control. These results support the scale-up of pilot components into nationwide program such as structured approaches in hypertension management, evidence base treatment and integration into community level care.
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