ArticleBMJ open2023
Perceived health system facilitators and barriers to integrated management of hypertension and type 2 diabetes in Kenya: a qualitative study.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Barriers and facilitators to integrating non-communicable disease care within primary healthcare systems in low-resource countries: a systematic review.BMC health services research · 2026Pooled it
- Factors Influencing the Uptake of Digital Health Interventions for Cardiovascular Disease Prevention Among Healthcare Providers: A Systematic Review.Global heart · 2026Pooled it
- Strategic development of integrated governance for type 2 diabetes Mellitus (T2DM) care in Indonesia: a mixed-methods approach.Global health action · 2026Article
- The acceptability, adoption and feasibility of mobile health interventions for diabetes and hypertension care among Ghanaian healthcare workers.PEC innovation · 2026Article
- Estimating investment costs to improve hypertension care in Lagos, Nigeria.Communications medicine · 2026Article
- Article
- Development of a collaborative chronic care model for management of cardiometabolic disease in low- and middle-income countries.PloS one · 2026Article
- A qualitative socioecological exploration of community health promoters' barriers and facilitators in cardiovascular disease prevention in Kenya.Frontiers in public health · 2026Article
- Health Literacy in People with Type 1 Diabetes: A Scoping Review.International journal of environmental research and public health · 2025Article
- Perceived Barriers to Hypertension Control: A Cross-Sectional Study Among Healthcare Providers in the Ashanti Region of Ghana.Health science reports · 2025Article
- Rethinking chronic care: how blended patient-centered care delivery and innovative financing models can contribute to achieving universal health coverage-a case study of an integrated approach in Kenya.Oxford open digital health · 2025Article
- Stakeholder perspectives on the barriers and facilitators to integrating cardiovascular disease and diabetes management at primary care in Kenya.PLOS global public health · 2025Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveUnderstanding the facilitators and barriers to managing hypertension and type 2 diabetes (T2D) will inform the design of a contextually appropriate integrated chronic care model in Kenya. We explored the perceived facilitators and barriers to the integrated management of hypertension and T2D in Kenya using the Rainbow Model of Integrated Care.
designThis was a qualitative study using data from a larger mixed-methods study on the health system response to chronic disease management in Kenya, conducted between July 2019 and February 2020. Data were collected through 44 key informant interviews (KIIs) and eight focus group discussions (FGDs).
settingMultistage sampling procedures were used to select a random sample of 12 study counties in Kenya.
participantsThe participants for the KIIs comprised purposively selected healthcare providers, county health managers, policy experts and representatives from non-state organisations. The participants for the FGDs included patients with hypertension and T2D. OUTCOME MEASURES: Patients' and providers' perspectives of the health system facilitators and barriers to the integrated management of hypertension and T2D in Kenya.
resultsThe clinical integration facilitators included patient peer support groups for hypertension and T2D. The major professional integration facilitators included task shifting, continuous medical education and integration of community resource persons. The national referral system, hospital insurance fund and health management information system emerged as the major facilitators for organisational and functional integration. The system integration facilitators included decentralisation of services and multisectoral partnerships. The major barriers comprised vertical healthcare services characterised by service unavailability, unresponsiveness and unaffordability. Others included a shortage of skilled personnel, a lack of interoperable e-health platforms and care integration policy implementation gaps.
conclusionsOur study identified barriers and facilitators that may be harnessed to improve the integrated management of hypertension and T2D. The facilitators should be strengthened, and barriers to care integration redressed.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.