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. 2023 May 4;4(1):47.
doi: 10.1186/s43058-023-00425-3.

Organizational readiness to implement task-strengthening strategy for hypertension management among people living with HIV in Nigeria

Juliet Iwelunmor  1 , Gbenga Ogedegbe  2   3 , Lisa Dulli  4 , Angela Aifah  2 , Ucheoma Nwaozuru  5 , Chisom Obiezu-Umeh  6 , Deborah Onakomaiya  7 , Ashlin Rakhra  2 , Shivani Mishra  2 , Calvin L Colvin  2 , Ebenezer Adeoti  6 , Okikiolu Badejo  4 , Kate Murray  4 , Henry Uguru  8 , Gabriel Shedul  8   9 , Erinn M Hade  2 , Daniel Henry  8 , Ayei Igbong  4 , Daphne Lew  10 , Geetha P Bansal  11 , Dike Ojji  8   12
Affiliations

Organizational readiness to implement task-strengthening strategy for hypertension management among people living with HIV in Nigeria

Juliet Iwelunmor et al. Implement Sci Commun. .

Abstract

Background: Hypertension (HTN) is highly prevalent among people living with HIV (PLHIV), but there is limited access to standardized HTN management strategies in public primary healthcare facilities in Nigeria. The shortage of trained healthcare providers in Nigeria is an important contributor to the increased unmet need for HTN management among PLHIV. Evidence-based TAsk-Strengthening Strategies for HTN control (TASSH) have shown promise to address this gap in other resource-constrained settings. However, little is known regarding primary health care facilities' capacity to implement this strategy. The objective of this study was to determine primary healthcare facilities' readiness to implement TASSH among PLHIV in Nigeria.

Methods: This study was conducted with purposively selected healthcare providers at fifty-nine primary healthcare facilities in Akwa-Ibom State, Nigeria. Healthcare facility readiness data were measured using the Organizational Readiness to Change Assessment (ORCA) tool. ORCA is based on the Promoting Action on Research Implementation in Health Services (PARIHS) framework that identifies evidence, context, and facilitation as the key factors for effective knowledge translation. Quantitative data were analyzed using descriptive statistics (including mean ORCA subscales). We focused on the ORCA context domain, and responses were scored on a 5-point Likert scale, with 1 corresponding to disagree strongly.

Findings: Fifty-nine healthcare providers (mean age 45; standard deviation [SD]: 7.4, 88% female, 68% with technical training, 56% nurses, 56% with 1-5 years providing HIV care) participated in the study. Most healthcare providers provide care to 11-30 patients living with HIV per month in their health facility, with about 42% of providers reporting that they see between 1 and 10 patients with HTN each month. Overall, staff culture (mean 4.9 [0.4]), leadership support (mean 4.9 [0.4]), and measurement/evidence-assessment (mean 4.6 [0.5]) were the topped-scored ORCA subscales, while scores on facility resources (mean 3.6 [0.8]) were the lowest.

Conclusion: Findings show organizational support for innovation and the health providers at the participating health facilities. However, a concerted effort is needed to promote training capabilities and resources to deliver services within these primary healthcare facilities. These results are invaluable in developing future strategies to improve the integration, adoption, and sustainability of TASSH in primary healthcare facilities in Nigeria.

Trial registration: NCT05031819.

Keywords: Hypertension; Task-strengthening.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Spot map of locations of health facilities studied in Akwa Ibom State, Nigeria
Fig. 2
Fig. 2
The proportion of responses for the context scale
See this image and copyright information in PMC

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