Key result
A primary care quality improvement initiative increases blood pressure screening rates by ~39 percentage points.
Why the study?
Less than half of people with hypertension in Ethiopia are diagnosed, and only one-third of adults visiting primary care facilities have their blood pressure screened.
Does a structured quality improvement initiative improve facility-based hypertension screening rates in adults visiting primary health care facilities in Ethiopia?
Does a structured quality improvement initiative improve facility-based hypertension screening rates in adults visiting primary health care facilities in Ethiopia?
Absolute Event Rate: 79.6% vs 41%
A structured quality improvement initiative optimizing existing clinical workflows and staff practices successfully doubled facility-based hypertension screening rates in Ethiopian primary care facilities.
Supports QI approaches for BP screening in Ethiopian primary care; hypothesis-generating for scalability and sustainability in other LMIC settings.
Less than half of people with hypertension in Ethiopia are diagnosed, and only one-third of adults visiting primary care facilities have their blood pressure (BP) screened. We implemented a quality improvement (QI) initiative across six facilities in Ethiopia to increase facility-based BP screening. Process mapping identified barriers, and interventions were tested in iterative QI cycles: establishing BP screening desks at key service points, ensuring the availability of validated BP devices, training staff in accurate measurement, standardizing documentation, and reviewing screening indicators in performance meetings. Between April 2024 and February 2025, monthly BP screening of adults without a hypertension diagnosis increased from 41.0% of 13,707 eligible adults to 79.6% of 14,270 eligible adults. Monthly hypertension program enrollments rose from 40 in April 2024 to 125 in February 2025. Strengthening primary health care systems to systematically measure BP for all adults visiting health facilities can significantly improve hypertension detection and treatment.
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Demissie et al. (2026) studied Undiagnosed hypertension. Quality improvement initiative vs. Routine care (baseline) was evaluated on Facility-based blood pressure screening rate. Implementation of a quality improvement initiative across six primary care facilities in Ethiopia increased monthly blood pressure screening among eligible adults from 41.0% to 79.6%.
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