Abstract:
Background: Ineffective referral networks in low- and middle-income countries hinders access to evidence based therapies by hypertensive patients, leading to high cardiovascular mortality and morbidity. The
STRENGTHS (Strengthening Referral Networks for Management of Hypertension Across Health Systems)
study evaluates strategies to improve referral processes utilizing the International Association of Public
Participation framework to engage stakeholders.
Objectives: This study sought to identify and engage key stakeholders involved in referral of patients in the
Ministry of Health, western Kenya.
Methods: Key stakeholders involved in policy formulation, provision, or consumption of public health care
service were mapped out and contacted by phone, letters, and emissaries to schedule meetings, explain
research objectives, and obtain feedback.
Results: Key stakeholders identified were the Ministry of Health, the Academic Model Providing Access to
Healthcare, health professionals, communities and their leadership, and patients. Engaging them resulted in
permission to contact research in their areas of jurisdiction and enabled collaboration in updating care
protocols with emphasis on timely and appropriate referrals.
Conclusions: Early stakeholder identification and engagement using the International Association of Public
Participation model eased explanation of research objectives, building consensus, and shaping the
interventions to improve the referral process.
