Abstract
The assessment of the capacity of Primary Health Care (PHC) settings for the management of hypertension is essential to identify areas for improving management outcomes. This study aimed to assess the capacity of PHC centers in Jordan to manage hypertension including the assessment of human resources, equipment, and infrastructure. All comprehensive PHC centers located in Irbid and Mafraq governorates in north of Jordan (n = 23) were assessed. An assessment tool from HEARTS Technical Package was adapted and used for assessment. All centers have general practitioners and half of the centers (n = 11, 47.8%) had at least one family doctor working full time. In only one center, all doctors, nurses, and other health workers were trained on the management of hypertension. All centers, except one, had at least one functional automatic blood pressure measuring devices (BPMDs). Almost two thirds of centers (43.5%) had no measuring tapes. ECG machines were present in all centers except two. One third (n = 8, 34.8%) of centers had no functional glucometers. The majority of health centres carry out the laboratory investigations. Educational materials on physical activity, hypertension, and diabetes were seen in four (17.4%) centers only. Necessary medications were always available in the majority of health centers. In conclusion, this assessment revealed many areas for improvement in human resources, equipment, infrastructures, and other resources, such as developing an updated guideline/protocol of hypertension management, training the PHC staff on these guidelines, providing PHC centers with the necessary equipment, and establishing e-registry to improve documentation of data.
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References
WHO. Hypertension key facts. 2020. https://www.who.int/news-room/fact-sheets/detail/hypertension.
Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365:217–23.
Forouzanfar MH, Liu P, Roth GA, Ng M, Biryukov S, Marczak L, et al. Global burden of hypertension and systolic blood pressure of at least 110 to 115 mmHg, 1990–2015. JAMA. 2017;317:165–82.
Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics-2015 update: a report from the American Heart Association. Circulation. 2015;131:e29–322.
Omran AR. The epidemiologic transition. A theory of the epidemiology of population change. Milbank Mem Fund Q. 1971;49:509–38.
World Health Organization. Jordan NCDs profile. 2016. https://www.who.int/nmh/countries/jor_en.pdf.
Khader Y, Batieha A, Jaddou H, Rawashdeh SI, El-Khateeb M, Hyassat D, et al. Hypertension in Jordan: prevalence, awareness, control, and its associated factors. Int J Hypertens. 2019;2019:3210617.
Jordan Ministry of Health. NCDs directorate. 2020. https://www.moh.gov.jo/.
Jaddou HY, Batieha AM, Khader YS, Kanaan AH, El-Khateeb MS, Ajlouni KM. Hypertension prevalence, awareness, treatment and control, and associated factors: results from a national survey, jordan. Int J Hypertens. 2011;2011:828797.
Paniagua-Avila A, Fort MP, Glasgow RE, Gulayin P, Hernández-Galdamez D, Mansilla K, et al. Monitoring and evaluation framework for hypertension programs. A collaboration between the Pan American Health Organization and World Hypertension League. J Clin Hypertens. 2018;20:984–90.
Department of Statistics. Statistical Yearbook of Jordan 2019. http://dosweb.dos.gov.jo/wp-content/uploads/2020/06/Population2019.pdf.
WHO. HEARTS Technical Package. 2020. https://www.who.int/cardiovascular_diseases/hearts/en/.
CDC. Field Epidemiology Training Program (FETP). 2018. https://www.cdc.gov/globalhealth/healthprotection/fetp/index.htm.
CDC. Promoting Team-Based Care to Improve High Blood Pressure Control. 2018. https://www.cdc.gov/dhdsp/pubs/guides/best-practices/team-based-care.htm.
Community Preventive Services Task Force. Cardiovascular disease prevention: tam-based care to improve blood pressure control. 2014. https://www.thecommunityguide.org/sites/default/files/assets/CVD-Team-Based-Care.pdf.
Smith CD, Balatbat C, Corbridge S, dopp AL, Fried J, Harter R, et al. NAM perspectives. Implementing optimal team-based care to reduce clinician burnout. Washington, DC: National Academy of Medicine; 2018. https://nam.edu/implementing-optimal-team-based-care-to-reduce-clinician-burnout.
Schottenfeld L, Petersen D, Peikes D, Ricciardi R, Burak H, McNellis R, et al. Creating patient-centered team-based primary care. AHRQ Pub. No. 16-0002-EF. Rockville, MD: Agency for Healthcare Research and Quality; 2016. https://pcmh.ahrq.gov/sites/default/files/attachments/creating-patient-centered-team-based-primary-care-white-paper.pdf.
Al-Azzam SI, Najjar RB, Khader YS. Awareness of physicians in Jordan about the treatment of high blood pressure according to the seventh report of the Joint National Committee (JNC VII). Eur J Cardiovasc Nurs. 2007;6:223–32.
WHO. HEARTS Technical Package. Access to essential medicines and technology. 2020. https://apps.who.int/iris/bitstream/handle/10665/260420/WHO-NMH-NVI-18.3-eng.pdf?sequence=1.
Mirdamadi A, Etebari M. Comparison of manual versus automated blood pressure measurement in intensive care unit, coronary care unit, and emergency room. ARYA Atheroscler. 2017;13:29–34.
Nerenberg KA, Zarnke KB, Leung AA, Dasgupta K, Butalia S, McBrien K, et al. Hypertension Canada’s 2018 guidelines for diagnosis, risk assessment, prevention, and treatment of hypertension in adults and children. Can J Cardiol. 2018;34:506–25. https://doi.org/10.1016/j.cjca.2018.02.022.
Mendis S, Al Bashir I, Dissanayake L, Varghese C, Fadhil I, Marhe E, et al. Gaps in capacity in primary care in low-resource settings for implementation of essential noncommunicable disease interventions. Int J Hypertens. 2012;2012:584041.
Al-Ahmadi H, Roland M. Quality of primary health care in Saudi Arabia: a comprehensive review. Int J Qual Health Care. 2005;17:331–46.
Adinan J, Manongi R, Temu GA, Kapologwe N, Marandu A, Wajanga B, et al. Preparedness of health facilities in managing hypertension & diabetes mellitus in Kilimanjaro, Tanzania: a cross sectional study. BMC Health Serv Res. 2019;19:537.
Al-Gelban KS, Khan MY, Al-Khaldi YM, Mahfouz AA, Abdelmoneim I, Daffalla A, et al. Adherence of primary health care physicians to hypertension management guidelines in the Aseer region of Saudi Arabia. Saudi J Kidney Dis Transpl. 2011;22:941–8.
Pakhare A, Kumar S, Goyal S, Joshi R. Assessment of primary care facilities for cardiovascular disease preparedness in Madhya Pradesh, India. BMC Health Serv Res. 2015;15:408.
WHO. Essential medicines for non-communicable diseases (NCDs). 2010. https://www.who.int/medicines/areas/policy/access_noncommunicable/EssentialMedicinesforNCDs.pdf?ua=1.
Robertson J, Macé C, Forte G, de Joncheere K, Beran D. Medicines availability for non-communicable diseases: the case for standardized monitoring. Glob Health. 2015;11:18.
WHO. Access to essential medicines and technology module. 2018. https://www.who.int/cardiovascular_diseases/hearts/en/.
WHO. The selection of essential medicines. 2002. http://apps.who.int/medicinedocs/pdf/s2296e/s2296e.pdf.
Shao PJ, Sawe HR, Murray BL, Mfinanga JA, Mwafongo V, Runyon MS. Profile of patients with hypertensive urgency and emergency presenting to an urban emergency department of a tertiary referral hospital in Tanzania. BMC Cardiovasc Disord. 2018;18:158.
Baumann BM, Abate NL, Cowan RM, Chansky ME, Rosa K, Boudreaux ED. Characteristics and referral of emergency department patients with elevated blood pressure. Acad Emerg Med. 2007;14:779–84.
Khayyati F, Motlagh ME, Kabir M, Kazemeini H, Gharibi F, Jafari N. The role of family physician in case finding, referral, and insurance coverage in the rural areas. Iran J Public Health. 2011;40:136–9.
WHO. Community Action for Health in Kyrgyzstan: an integrated approach of health promotion and primary health care provision in rural areas to scale up hypertension detection. 2015. http://www.euro.who.int/__data/assets/pdf_file/0004/308227/Good-Practice-Brief-Community-action-health-Kyrgyzstan.pdf?ua=1.
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The study was funded by the Resolve to Save Lives. Funding body provided financial support to conduct the study and has no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.
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Al-Hadeethi, O., Al Nsour, M., Khader, Y. et al. The capacity of primary health care centers in Jordan to manage hypertension: areas for improvement. J Hum Hypertens 36, 473–481 (2022). https://doi.org/10.1038/s41371-020-00433-z
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DOI: https://doi.org/10.1038/s41371-020-00433-z
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