Factors contributing to uncontrolled high blood pressure in Ekurhuleni, Johannesburg: the community health workers’ perspectives

Date
2024
Journal Title
Journal ISSN
Volume Title
Publisher
University of the Witwatersrand, Johannesburg
Abstract
Background: Uncontrolled high blood pressure has become a concern in underserved communities of South Africa due to its consequence resulting in rising cardiovascular and cerebrovascular diseases. Community health workers at a primary care level offer door to door services for patients with chronic diseases and are often key in health education, health promotion, and disease monitoring. Understanding the voice of the community health workers regarding factors that contributes to uncontrolled high blood pressure for their patients can provide insight on strategies for future intervention programme from a systems, patient, and community perspectives. Aim: To explore community health workers' perceptions on factors that contribute to uncontrolled high blood pressure in adults living in Ekurhuleni South sub-district, Johannesburg. Methods: A descriptive, qualitative study design was used for this study. In-depth face-to- face interviews were conducted with 22 community health workers from four communities within the South sub-district in Ekurhuleni, Gauteng. The interviews focused on: the community health workers knowledge on measures used to control high blood pressure, the community health workers opinions on barriers and facilitators contributing to uncontrolled high blood pressure for their patients, and lastly their perceptions on strategies which can be used to improve the control of high blood pressure. Data analysis following thematic analysis was used in this study. An inductive approach was used to generate codes, themes, categories and to analyse the data. Results: Analysis of the qualitative data revealed six themes. Community health workers possessed knowledge regarding the symptoms, causes and complications of uncontrolled high blood pressure however, they didn’t fully comprehend the physiological concept of blood pressure and uncontrolled high blood pressure. It can be noted that the type of advises and education which community health workers provided their patients with are generally very contextualized and simple. Multiple barriers included financial, personal, social, system, medication and cultural and traditional issues. Facilitators included government and health workforce assistance, improvement of clinic accessibility, inter and intra collaboration from multiple sources such as media, other health professionals as well as patient centred approaches. Strategies to improve control of high blood pressure included improved team work, awareness creation, holistic healthcare, improved access to clinic facilities, system related improvements and patient initiatives. Conclusion: Community health workers in this study have knowledge regarding the causes, symptoms and complications of uncontrolled HBP. Multiple barriers to controlling high blood pressure included financial, social system, personal, cultural and patient barriers. The facilitators which were identified required a multidisciplinary approach. Interventions which the community health workers provide to patients are reported to be easy to follow and usually contextualized to the patient needs. Strategies required to improve the control of high blood pressure in this community are easy to implement with less assistance required from the health care system
Description
A dissertation submitted to the faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfillment of the requirements for the degree of Masters in Physiotherapy Johannesburg, 2023
Keywords
Community health workers, Perceptions, Uncontrolled high blood pressure, Barriers, Facilitators, UCTD
Citation
Dawood, Zaheerah. (2024). Factors contributing to uncontrolled high blood pressure in Ekurhuleni, Johannesburg: the community health workers’ perspectives [Master’s dissertation, University of the Witwatersrand, Johannesburg]. WireDSpace.