Facilitators of Blood Pressure Control Among Treated Patients in Public Clinics in Botswana
Vincent Setlhare, Yaone Bogatsu, Nabila Youssouf, Julius C MwitaABSTRACT
Background
High blood pressure (BP) prevalence is increasing in low‐ and middle‐income countries, leading to increased morbidity and mortality. This compromises Sustainable Development Goal number 3—to ensure healthy lives for all people. Most BP patients do not attain normal BP despite treatment. Uncontrolled BP causes cardiovascular diseases, kidney disease and early death. It is therefore prudent to know the facilitators of BP control among treated patients.
Methods
The aim of this study was to explore the facilitators of BP control among treated patients in two public primary healthcare (PHC) clinics in Gaborone, Botswana. Participants were purposively selected to ensure the selection of participants with good knowledge of high BP. These were patients with more than 1 year experience of BP treatment, healthcare workers (HCWs) with more than 3 years’ experience of treating BP patients, and district health managers. Semi‐structured interviews were used to collect data until saturation, from BP patients, nurses, doctors and district health managers. Interviews were audio recorded, transcribed and then coded by three authors. The codes were iteratively grouped and regrouped into themes several times to produce a codebook. The codebook and transcripts were uploaded into NVivo for analysing all the transcripts.
Results
Eighteen participants (six patients, four nurses, four doctors and four district health managers) were interviewed. The themes that were extracted from the data included health system, HCW, patient and socio‐economic related factors.
Conclusion
The perceived facilitators of BP control among patients receiving BP treatment included central government, local government and public PHC clinic level factors. Perceived facilitating factors also included patient, and HCW components. The study findings present a firm base from which more extensive qualitative and quantitative studies can be made to confirm or disprove the generalisability of these findings to all the public PHC clinics in Botswana.