Hypertension

Context

In Kenya, hypertension represents a growing public health challenge, particularly in rural and resource-limited areas like Homa Bay County in Kenya, where access to chronic care remains limited. 

The 2021 guideline by the World Health Organization (WHO) marks a significant shift by clearly advocating for combination therapy, particularly emphasizing the use of Single Pill Combination’s (SPC) as the preferred initial treatment to enhance treatment adherence. These recommendations are integrated into the WHO's simplified algorithms, aiming to streamline and optimize hypertension management. Similarly, the 2018 Kenya national Guidelines For Cardiovascular Diseases Management underscores the benefits of combination therapy, including fixed dose combinations, in minimizing treatment toxicity, reducing side effects, and improving adherence. However, despite the endorsement of these guidelines, their implementation within the public sector remains limited.

To remedy this situation, differentiated Service Delivery Models (DSDM), initially developed for HIV care, are increasingly being adapted to manage hypertension.

Location 

Homabay County, Kenya

Study Design 

Mixed quantitative and quantitative study

Tentative End date  

December 2027

Status 

data collection and qualitative study in progress

Objectives

This study encompasses multiple objectives: 

1. To assess the feasibility and acceptability of introduction of a simplified hypertension algorithm including SPCs by service providers 

2. To assess the feasibility and acceptability of the simplified algorithm DSDM options like those within the national HIV program  by patients

3. To assess the feasibility of HIV-NCD integration care within the DSDM model in patients with co-morbidities 

4. To establish a profile of individual characteristics of patients by chosen DSDM

5. To explore the socio-cultural and contextual determinants of effective implementation and efficacy of the DSD