Health system barriers to hypertension care in Peru: Rapid assessment to inform organizational-level change.
Traditional patient- and provider-level hypertension interventions have proven insufficient to halt hypertension as the leading cause of morbidity and mortality globally. Systems-level interventions are required to address factors challenging hypertension control across a social ecological framework...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2024-01-01
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| Series: | PLOS Global Public Health |
| Online Access: | https://doi.org/10.1371/journal.pgph.0002404 |
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| author | Kendra N Williams Janeth Tenorio-Mucha Karina Campos-Blanco Lindsay J Underhill Armando Valdés-Velásquez Antonia Fuentes Herbozo Laura K Beres Lisa de las Fuentes Lucy Cordova-Ascona Zoila Vela-Clavo Gonzalo Mariano Cuentas-Canal Juan Carlos Mendoza-Velasquez Sonia Mercedes Paredes-Barriga Raquel Hurtado La Rosa Makeda Williams Elvin H Geng William Checkley Joel Gittelsohn Victor G Davila-Roman Stella M Hartinger-Peña |
| author_facet | Kendra N Williams Janeth Tenorio-Mucha Karina Campos-Blanco Lindsay J Underhill Armando Valdés-Velásquez Antonia Fuentes Herbozo Laura K Beres Lisa de las Fuentes Lucy Cordova-Ascona Zoila Vela-Clavo Gonzalo Mariano Cuentas-Canal Juan Carlos Mendoza-Velasquez Sonia Mercedes Paredes-Barriga Raquel Hurtado La Rosa Makeda Williams Elvin H Geng William Checkley Joel Gittelsohn Victor G Davila-Roman Stella M Hartinger-Peña |
| author_sort | Kendra N Williams |
| collection | DOAJ |
| description | Traditional patient- and provider-level hypertension interventions have proven insufficient to halt hypertension as the leading cause of morbidity and mortality globally. Systems-level interventions are required to address factors challenging hypertension control across a social ecological framework, an under-studied topic particularly salient in low- and middle-income countries (LMICs) such as Peru. To inform such interventions, we sought to identify key health systems barriers to hypertension care in Puno, Peru. A participatory stakeholder workshop (October 2021) and 21 in-depth interviews (October 2021-March 2022) were conducted with 55 healthcare professionals (i.e., doctors, nurses, midwives, dentists, nutritionists), followed by a deductive qualitative analysis of transcripts and notes. Participating healthcare providers indicated that low prioritization and lack of national policies for hypertension care have resulted in limited funding and lack of societal-level prevention efforts. Additionally, limited cultural consideration, both in national guidelines as well as by some providers in Puno, results in inadequate care that may not align with local traditions. Providers highlighted that patient care is also hampered by inadequate distribution and occasional shortages of medications and equipment, as well as a lack of personnel and limited opportunities for training in hypertension. Multiple incompatible health information systems, complicated referral systems, and geographic barriers additionally hinder continuity of care and care seeking. Insights gained from health providers on the healthcare system in Puno provide essential contextual information to inform development of organizational-level strategies necessary to improve provider and patient behaviors to achieve better hypertension care outcomes. |
| format | Article |
| id | doaj-art-ac70adae3ef74df9a993f49fd994dc5c |
| institution | Kabale University |
| issn | 2767-3375 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj-art-ac70adae3ef74df9a993f49fd994dc5c2025-01-08T05:51:37ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752024-01-0148e000240410.1371/journal.pgph.0002404Health system barriers to hypertension care in Peru: Rapid assessment to inform organizational-level change.Kendra N WilliamsJaneth Tenorio-MuchaKarina Campos-BlancoLindsay J UnderhillArmando Valdés-VelásquezAntonia Fuentes HerbozoLaura K BeresLisa de las FuentesLucy Cordova-AsconaZoila Vela-ClavoGonzalo Mariano Cuentas-CanalJuan Carlos Mendoza-VelasquezSonia Mercedes Paredes-BarrigaRaquel Hurtado La RosaMakeda WilliamsElvin H GengWilliam CheckleyJoel GittelsohnVictor G Davila-RomanStella M Hartinger-PeñaTraditional patient- and provider-level hypertension interventions have proven insufficient to halt hypertension as the leading cause of morbidity and mortality globally. Systems-level interventions are required to address factors challenging hypertension control across a social ecological framework, an under-studied topic particularly salient in low- and middle-income countries (LMICs) such as Peru. To inform such interventions, we sought to identify key health systems barriers to hypertension care in Puno, Peru. A participatory stakeholder workshop (October 2021) and 21 in-depth interviews (October 2021-March 2022) were conducted with 55 healthcare professionals (i.e., doctors, nurses, midwives, dentists, nutritionists), followed by a deductive qualitative analysis of transcripts and notes. Participating healthcare providers indicated that low prioritization and lack of national policies for hypertension care have resulted in limited funding and lack of societal-level prevention efforts. Additionally, limited cultural consideration, both in national guidelines as well as by some providers in Puno, results in inadequate care that may not align with local traditions. Providers highlighted that patient care is also hampered by inadequate distribution and occasional shortages of medications and equipment, as well as a lack of personnel and limited opportunities for training in hypertension. Multiple incompatible health information systems, complicated referral systems, and geographic barriers additionally hinder continuity of care and care seeking. Insights gained from health providers on the healthcare system in Puno provide essential contextual information to inform development of organizational-level strategies necessary to improve provider and patient behaviors to achieve better hypertension care outcomes.https://doi.org/10.1371/journal.pgph.0002404 |
| spellingShingle | Kendra N Williams Janeth Tenorio-Mucha Karina Campos-Blanco Lindsay J Underhill Armando Valdés-Velásquez Antonia Fuentes Herbozo Laura K Beres Lisa de las Fuentes Lucy Cordova-Ascona Zoila Vela-Clavo Gonzalo Mariano Cuentas-Canal Juan Carlos Mendoza-Velasquez Sonia Mercedes Paredes-Barriga Raquel Hurtado La Rosa Makeda Williams Elvin H Geng William Checkley Joel Gittelsohn Victor G Davila-Roman Stella M Hartinger-Peña Health system barriers to hypertension care in Peru: Rapid assessment to inform organizational-level change. PLOS Global Public Health |
| title | Health system barriers to hypertension care in Peru: Rapid assessment to inform organizational-level change. |
| title_full | Health system barriers to hypertension care in Peru: Rapid assessment to inform organizational-level change. |
| title_fullStr | Health system barriers to hypertension care in Peru: Rapid assessment to inform organizational-level change. |
| title_full_unstemmed | Health system barriers to hypertension care in Peru: Rapid assessment to inform organizational-level change. |
| title_short | Health system barriers to hypertension care in Peru: Rapid assessment to inform organizational-level change. |
| title_sort | health system barriers to hypertension care in peru rapid assessment to inform organizational level change |
| url | https://doi.org/10.1371/journal.pgph.0002404 |
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