Sarah Blackstone1, Juliet Iwelunmor2, Jacob Plange-Rhule3, Joyce Gyamfi4, Nana Kofi Quakyi5, Micheal Ntim6, Gbenga Ogedegbe7. 1. Doctoral Candidate, Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, IL. 2. Assistant Professor, Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, IL. 3. Professor, Department of Physiology Kwame Nkrumah, University of Science and Technology, Kumasi, Ghana. 4. Research Coordinator, Department of Population Health, New York University School of Medicine, New York, NY. 5. Doctoral Student, Department of Population Health, New York University School of Medicine, New York, NY. 6. Research Coordinator, Department of Physiology Kwame Nkrumah, University of Science and Technology, Kumasi, Ghana. 7. Professor and Director, Department of Population Health, New York University School of Medicine, New York, NY.
Abstract
BACKGROUND: The use of task-shifting is an increasingly widespread delivery approach for health interventions targeting prevention, treatment, and control of hypertension in adults living in sub-Saharan Africa (SSA). Addressing a gap in the literature, this research examined the sustainability of an ongoing task-shifting strategy for hypertension (TASSH) from the perspectives of community health nurses (CHNs) implementing the program. METHODS: We used concept-mapping, a mixed-methods participatory approach to understand CHNs' perceptions of barriers and enablers to sustaining a task-shifting program. Participants responded to focal prompts, eliciting statements regarding perceived barriers and enablers to sustaining TASSH, and then rated these ideas based on importance to the research questions and feasibility to address. Twenty-eight community health nurses (21 women, 7 men) from the Ashanti region of Ghana completed the concept-mapping process. RESULTS: Factors influencing sustainability were grouped into five categories: Limited Drug Supply, Financial Support, Provision of Primary Health Care, Personnel Training, and Patient-Provider Communication. The limited supply of antihypertensive medication was considered by CHNs as the most important item to address, while providing training for intervention personnel was considered most feasible to address. LINKING EVIDENCE TO ACTION: This study's findings highlight the importance of examining nurses' perceptions of factors likely to influence the sustainability of evidence-based, task-shifting interventions. Nurses' perceptions can guide the widespread uptake and dissemination of these interventions in resource-limited settings.
BACKGROUND: The use of task-shifting is an increasingly widespread delivery approach for health interventions targeting prevention, treatment, and control of hypertension in adults living in sub-Saharan Africa (SSA). Addressing a gap in the literature, this research examined the sustainability of an ongoing task-shifting strategy for hypertension (TASSH) from the perspectives of community health nurses (CHNs) implementing the program. METHODS: We used concept-mapping, a mixed-methods participatory approach to understand CHNs' perceptions of barriers and enablers to sustaining a task-shifting program. Participants responded to focal prompts, eliciting statements regarding perceived barriers and enablers to sustaining TASSH, and then rated these ideas based on importance to the research questions and feasibility to address. Twenty-eight community health nurses (21 women, 7 men) from the Ashanti region of Ghana completed the concept-mapping process. RESULTS: Factors influencing sustainability were grouped into five categories: Limited Drug Supply, Financial Support, Provision of Primary Health Care, Personnel Training, and Patient-Provider Communication. The limited supply of antihypertensive medication was considered by CHNs as the most important item to address, while providing training for intervention personnel was considered most feasible to address. LINKING EVIDENCE TO ACTION: This study's findings highlight the importance of examining nurses' perceptions of factors likely to influence the sustainability of evidence-based, task-shifting interventions. Nurses' perceptions can guide the widespread uptake and dissemination of these interventions in resource-limited settings.
Authors: Guanyang Zou; Sophie Witter; Lizzie Caperon; John Walley; Kiran Cheedella; Reynold G B Senesi; Haja Ramatulai Wurie Journal: BMC Public Health Date: 2020-07-29 Impact factor: 3.295