Abstract:
Background—
Hypertension is the leading global risk factor for mortality. Hypertension
treatment and control rates are low worldwide, and insufficient human resource capacity is among
the contributing factors. Thus, a critical component of hypertension management is to develop
novel and effective solutions to the human resources challenge. One potential solution is task
redistribution and nurse management of hypertension in these settings.
Methods—
This study investigates whether nurses can effectively reduce blood pressure in
hypertensive patients in rural western Kenya and, by extension, throughout sub-Saharan Africa.
An initial phase of qualitative inquiry will assess facilitators and barriers of nurse management of
hypertension. In addition, we will perform usability and feasibility testing of a novel, electronic
tablet-based integrated decision support and record-keeping tool for the nurses. An impact
evaluation of a pilot program for nurse-based management of hypertension will be performed.
Finally, a needs-based workforce estimation model will be utilized to estimate the nurse workforce
requirements for stable, long-term treatment of hypertension throughout western Kenya.
Results—
The primary outcome measure of the impact evaluation will be the change in systolic
blood pressure of hypertensive individuals assigned to nurse-based management after one year of
follow-up. The workforce estimation modeling output will be full-time equivalents of nurses.Conclusions—
This study will provide evidence regarding the effectiveness of strategies to
optimize task redistribution and nurse-based management of hypertension that can be applicable to
non-communicable disease management in low- and middle-income countries.
