Practices and factors influencing screening for hypertension among adults in primary health care facilities in Tororo Municipality: A facility based cross sectional study

Abstract

Introduction: Outpatient units at the health facilities often miss screening adult patients for hypertension who usually come to their care, yet hypertension is a growing health problem of public health concern in Sub Saharan Africa. The increasing burden of hypertension is attributed to growing urbanization, adoption of unhealthy lifestyles and an ageing population. In the face of increasing prevalence of hypertension many Ugandans are not aware of this “silent” killer. Objective: To establish hypertension screening proportion for adult patients, and factors that influenced screening among adults in primary healthcare facilities in Tororo Municipality. Methods: The study was a facility-based cross sectional study, conducted at primary healthcare facilities in Tororo Municipality, Tororo District. To determine the proportion of patients screened for hypertension at outpatient department (OPD), we administered an exit patient interview. To determine practices and factors that influenced screening at the OPD, we administered semi-structured questionnaire to health workers, a key informant interview to in-charges of primary healthcare facilities, and an observation checklist at the OPD. Quantitative data was analysed using STATA version 14 using descriptive analysis, bivariate and multivariate analysis. Qualitative data was analysed with the help of Atlas.ti 6.0, a data management software. Results: Only 18% of adult patients accessing OPD care in primary healthcare facilities in Tororo municipality were screened for hypertension. The key factors influencing hypertension screening were: availability of screening equipment, drugs, patient overload, inadequate staffing, symptoms presented by patients and data capture weaknesses. Patient-related factors that influenced screening were; male gender (APR=0.57 CI=0.36-0.93), patients’ religion (APR=2.08 CI=1.10-3.93), and time elapsed since the previous blood pressure measurement (APR=12.60 CI=1.32-120.12). Conclusion and recommendation: Screening for hypertension at OPD in primary healthcare facilities was unacceptably low. Primary healthcare facilities and the ministry of health should emphasize the importance of hypertension screening to health workers, provide screening guidelines and equipment, offer regular training for screening and improve staffing levels at these facilities.