ArticlePrimary health care research & development2025
Factors contributing to uncontrolled hypertension in Ekurhuleni District, South Africa: the community health workers' perspectives. A qualitative analysis.
Article in Primary health care research & development, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
backgroundIn South Africa, community health workers (CHWs) provide home-based care and health promotion for patients with chronic conditions like hypertension. However, their views on patients' poor blood pressure control remain unclear. Understanding CHWs' perspectives could inform future community-level strategies for improving blood pressure management.
objectivesTo explore CHWs' experiences about factors contributing to uncontrolled hypertension among adults living in a South African District.
methodsA qualitative exploratory design, based on 22 face-to-face, semi-structured interviews with CHW. Data was transcribed and analysed manually using thematic analysis.
findingsFour themes emerged: (1) adequate knowledge about blood pressure and hypertension. However, lack of comprehension about the physiological concept of blood pressure and hypertension, (2) interventions used for hypertension control were contextualized and very simple, (3) contextual barriers to hypertension control included financial, personal, systemic, medication as well as cultural and traditional factors, (4) strategies to improve hypertension control included improved team work, awareness creation, holistic healthcare, improved access to clinic facilities, system-related improvements and patient initiatives.
conclusionCommunity health workers (CHWs) demonstrated sufficient knowledge of hypertension, highlighting the need to strengthen and standardize their training, supervision, and support. Their patient advice was practical and context-specific. To address barriers and stigma around hypertension, CHWs should lead awareness campaigns and engage in community-based exercise and support groups, with help from rehabilitation teams. Collaborating with local police and community leaders to address violence, alcohol, and crime, along with initiatives like community gardens, multidisciplinary teamwork, and more frequent home visits, could further improve hypertension control.
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