Stakeholder perspectives to inform the implementation of a community health worker-delivered home management of hypertension intervention in Zimbabwe
Objective Implementing evidence-based innovations often fails to translate into meaningful outcomes in practice due to dynamic real-world contextual factors. Identifying these influencing factors is pivotal to implementation success. This study aimed to determine the barriers and facilitators of imp...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/12/e085211.full |
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| author | Paddington Tinashe Mundagowa Malvin Musariri Pamela Magande Tendai Hlabangana Linda Jane Mukwambo Pemberai Zambezi Priscillah Muchemwa-Munasirei Fadzai Mukora-Mutseyekwa |
| author_facet | Paddington Tinashe Mundagowa Malvin Musariri Pamela Magande Tendai Hlabangana Linda Jane Mukwambo Pemberai Zambezi Priscillah Muchemwa-Munasirei Fadzai Mukora-Mutseyekwa |
| author_sort | Paddington Tinashe Mundagowa |
| collection | DOAJ |
| description | Objective Implementing evidence-based innovations often fails to translate into meaningful outcomes in practice due to dynamic real-world contextual factors. Identifying these influencing factors is pivotal to implementation success. This study aimed to determine the barriers and facilitators of implementing a community health worker (CHW)-delivered home management of hypertension (HoMHyper) intervention from a stakeholder’s perspective using the Consolidated Framework for Implementation Research (CFIR).Design Exploratory qualitative study.Setting Five primary healthcare facilities in Mutare City, Zimbabwe.Participants 25 CHWs, 10 health facility nurses and 3 Mutare City health administrators.Results Perceived barriers to implementation of the HoMHyper intervention were staff shortage, patient privacy and confidentiality, limited access to antihypertensive medication, CHW incentivisation and equipment shortage, as well as patient knowledge and beliefs about hypertension. The proposed intervention was superior to the current practice, easy to implement and adaptable in the local context. Perceived facilitating factors were commitment from health system leadership, CHW training and support, regular engagement between CHWs and health providers, community partnerships, and CHW self-efficacy and knowledge and skills.Conclusion Integrating CHWs into chronic disease management can potentially improve health service access in low-resource settings. Well-coordinated planning guided by implementation evidence frameworks such as the CFIR significantly enhances the identification of important barriers and facilitators to inform implementation. |
| format | Article |
| id | doaj-art-4d0822a61a914c80918290dc7e3030d9 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-4d0822a61a914c80918290dc7e3030d92025-01-14T16:35:10ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2024-085211Stakeholder perspectives to inform the implementation of a community health worker-delivered home management of hypertension intervention in ZimbabwePaddington Tinashe Mundagowa0Malvin Musariri1Pamela Magande2Tendai Hlabangana3Linda Jane Mukwambo4Pemberai Zambezi5Priscillah Muchemwa-Munasirei6Fadzai Mukora-Mutseyekwa71 Africa University, Mutare, Manicaland, Zimbabwe3 University of Wolverhampton, Wolverhampton, UK2 University of South Carolina Arnold School of Public Health, Columbia, South Carolina, USA1 Africa University, Mutare, Manicaland, Zimbabwe1 Africa University, Mutare, Manicaland, Zimbabwe1 Africa University, Mutare, Manicaland, Zimbabwe4 Africa University College of Social Sciences Theology Humanities and Education, Mutare, Zimbabwe1 Africa University, Mutare, Manicaland, ZimbabweObjective Implementing evidence-based innovations often fails to translate into meaningful outcomes in practice due to dynamic real-world contextual factors. Identifying these influencing factors is pivotal to implementation success. This study aimed to determine the barriers and facilitators of implementing a community health worker (CHW)-delivered home management of hypertension (HoMHyper) intervention from a stakeholder’s perspective using the Consolidated Framework for Implementation Research (CFIR).Design Exploratory qualitative study.Setting Five primary healthcare facilities in Mutare City, Zimbabwe.Participants 25 CHWs, 10 health facility nurses and 3 Mutare City health administrators.Results Perceived barriers to implementation of the HoMHyper intervention were staff shortage, patient privacy and confidentiality, limited access to antihypertensive medication, CHW incentivisation and equipment shortage, as well as patient knowledge and beliefs about hypertension. The proposed intervention was superior to the current practice, easy to implement and adaptable in the local context. Perceived facilitating factors were commitment from health system leadership, CHW training and support, regular engagement between CHWs and health providers, community partnerships, and CHW self-efficacy and knowledge and skills.Conclusion Integrating CHWs into chronic disease management can potentially improve health service access in low-resource settings. Well-coordinated planning guided by implementation evidence frameworks such as the CFIR significantly enhances the identification of important barriers and facilitators to inform implementation.https://bmjopen.bmj.com/content/14/12/e085211.full |
| spellingShingle | Paddington Tinashe Mundagowa Malvin Musariri Pamela Magande Tendai Hlabangana Linda Jane Mukwambo Pemberai Zambezi Priscillah Muchemwa-Munasirei Fadzai Mukora-Mutseyekwa Stakeholder perspectives to inform the implementation of a community health worker-delivered home management of hypertension intervention in Zimbabwe BMJ Open |
| title | Stakeholder perspectives to inform the implementation of a community health worker-delivered home management of hypertension intervention in Zimbabwe |
| title_full | Stakeholder perspectives to inform the implementation of a community health worker-delivered home management of hypertension intervention in Zimbabwe |
| title_fullStr | Stakeholder perspectives to inform the implementation of a community health worker-delivered home management of hypertension intervention in Zimbabwe |
| title_full_unstemmed | Stakeholder perspectives to inform the implementation of a community health worker-delivered home management of hypertension intervention in Zimbabwe |
| title_short | Stakeholder perspectives to inform the implementation of a community health worker-delivered home management of hypertension intervention in Zimbabwe |
| title_sort | stakeholder perspectives to inform the implementation of a community health worker delivered home management of hypertension intervention in zimbabwe |
| url | https://bmjopen.bmj.com/content/14/12/e085211.full |
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