ArticleBMC public health2014
Hypertension education and adherence in South Africa: a cost-effectiveness analysis of community health workers.
Article in BMC public health, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 10 of them syntheses that pooled it.
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Who cites it
47 citing papers in PubMed, 10 syntheses or guidelines pooled it, 81 citations in OpenAlex.
- Decision-analytic models in the economic evaluation of community health worker programmes globally: a systematic review.BMJ global health · 2026Pooled it
- Pooled it
- The costs of interventions for type 2 diabetes mellitus, hypertension and cardiovascular disease in South Africa - a systematic literature review.BMC public health · 2022Pooled it
- The economic burden of treating uncomplicated hypertension in Sub-Saharan Africa: a systematic literature review.BMC public health · 2022Pooled it
- Pooled it
- A Systematic Review of Economic Evidence on Community Hypertension Interventions.American journal of preventive medicine · 2017Pooled it
- Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries.Human resources for health · 2017Pooled it
- Quality Improvement for Cardiovascular Disease Care in Low- and Middle-Income Countries: A Systematic Review.PloS one · 2016Pooled it
- Costs and cost-effectiveness of community health workers: evidence from a literature review.Human resources for health · 2015Pooled it
- Task-sharing interventions for cardiovascular risk reduction and lipid outcomes in low- and middle-income countries: A systematic review and meta-analysis.Journal of clinical lipidologyPooled it
- The cost-effectiveness of peer education on medication adherence in the elderly with hypertension: a randomized controlled trial.BMC public health · 2024Trial
- Cost-effectiveness of a Multicomponent Intervention for Hypertension Control in Low-Income Settings in Argentina.JAMA network open · 2021Trial
- Community-based interventions for non-communicable diseases in Africa: a scoping review of scope, effectiveness, and implementation factors.BMC public health · 2026Article
- The potential health effects of taxing sugar-sweetened drinks in Egypt: An epidemiologic-economic modelling study.Public health in practice (Oxford, England) · 2026Article
- Article
- Factors contributing to uncontrolled hypertension in Ekurhuleni District, South Africa: the community health workers' perspectives. A qualitative analysis.Primary health care research & development · 2025Article
- Application of decision analytic modelling to cardiovascular disease prevention in Sub-Saharan Africa: a systematic review.Communications medicine · 2025Article
- Pharmaceutical intervention for hypertension in a rural district of the Republic of Zambia: a model-based economic evaluation.BMJ open · 2024Article
- The role of community health workers in the management of hypertension in Nigeria.BMC primary care · 2024Article
- Potential health and economic impact of achieving Kenya's overweight and obesity reduction target: a modelling study.BMJ public health · 2024Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo determine whether training community health workers (CHWs) about hypertension in order to improve adherence to medications is a cost-effective intervention among community members in South Africa.
methodsWe used an established Markov model with age-varying probabilities of cardiovascular disease (CVD) events to assess the benefits and costs of using CHW home visits to increase hypertension adherence for individuals with hypertension and aged 25-74 in South Africa. Subjects considered for CHW intervention were those with a previous diagnosis of hypertension and on medications but who had not achieved control of their blood pressure. We report our results in incremental cost-effectiveness ratios (ICERs) in US dollars per disability-adjusted life-year (DALY) averted.
resultsThe annual cost of the CHW intervention is about $8 per patient. This would lead to over a 2% reduction in CVD events over a life-time and decrease DALY burden. Due to reductions in non-fatal CVD events, lifetime costs are only $6.56 per patient. The CHW intervention leads to an incremental cost-effectiveness ratio of $320/DALY averted. At an annual cost of $6.50 or if the blood pressure reduction is 5 mmHg or greater per patient the intervention is cost-saving.
conclusionsAdditional training for CHWs on hypertension management could be a cost-effective strategy for CVD in South Africa and a very good purchase according to World Health Organization (WHO) standards. The intervention could also lead to reduced visits at the health centres freeing up more time for new patients or reducing the burden of an overworked staff at many facilities.
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