Hypertension Management at Primary Healthcare in Kisumu County, Kenya: Barriers for Health Practice and Policy

Background: Globally, approximately1.4 billion individuals are affected by Hypertension, and projections indicate an increase to 1.6 billion by 2025. Despite the availability of Hypertension management service, utilization remains low, particularly in low resource settings. Understanding gaps in service delivery is essential to improve utilization and treatment outcomes. Objective: This study assessed the delivery and utilization of Hypertension management services at Primary Healthcare facilities in Kisumu County and identified barriers to inform health practices and policy. Method: A descriptive cross-sectional mixed-methods design was employed. Quantitative data collected from 27 facilities and 274 Hypertensive patients, while qualitative data included In-depth interviews with 14 healthcare workers, 4 focus group discussions with Community Health Promoters, and key informant interviews with 4 health managers. Data analyzed using SPSS and NVIVO. Results: Only 15% of the facilities provided all Hypertension services. Treatment guidelines were available in 37% of the facilities and just 26% of healthcare workers had received recent Hypertension training. Among adult patient, 82% were screened for high Blood Pressure, and 4% had elevated readings. Six key barriers identified: low disease awareness, poor treatment adherence, financial constraints, limited provider capacity, inadequate supplies and poor accessibility. Conclusion: Primary Healthcare facilities in Kisumu County are inadequately prepared to manage Hypertension effectively. Strengthening providers’ capacity, ensuring availability of guidelines and integration of Hypertension services are essential. Policy reform and increased health budgets to equip facilities with resources needed for Hypertension prevention and management could enhance service utilization and improve treatment outcomes in Kisumu County and similar setting.