An exploratory study on the quality of patient screening and counseling for hypertension management in Tanzania.

BackgroundThe global burden of hypertension, currently estimated at 1 billion, is a leading Non-Communicable Disease (NCD) in Sub Saharan Africa. In Tanzania, the reported prevalence of hypertension is 25%. Inherent limitations of the healthcare system to control hypertension include inadequate provider knowledge, system capacity, medication access, and patient awareness, all of which hinder effective screening and disease management. To assess the quality of hypertension screening and patient counseling, we conducted a study in an ambulatory setting in Tanzania.MethodsObservations of patient screening were conducted on 69 adult patients during routine outpatient care and screening camps. In addition, 33 healthcare providers participated in a pre-post knowledge assessment after observing instructional training videos.ResultsPatient observations indicated that blood pressure (BP) measurement was explained to 65% of patients, and 77% of the measurements were made with mercury sphygmomanometers. For several aspects of BP measurement, nurses performed better than doctors: patient's arm supported on a flat surface (doctors, 58% vs nurses 67%, pConclusionEnhancing knowledge and performance competencies of health providers at the primary care level is a critical prerequisite for effective hypertension management in low resource settings