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Health system barriers to hypertension care in Peru

Rapid assessment to inform organizational-level change

Bibliographic Data

ID19592510
AuthorsKendra N Williams (0000-0001-9697-048X, Johns Hopkins University, corresponding author), Janeth Tenorio-Mucha, Janeth Tenorio‐Mucha (0000-0003-2837-5149, Universidad Peruana Cayetano Heredia, corresponding author), Karina Campos-Blanco (Universidad Peruana Cayetano Heredia, corresponding author), Lindsay J Underhill (0000-0002-1511-812X, Washington University in St. Louis, corresponding author), Armando Valdés-Velásquez (0000-0003-2450-8645, Universidad Peruana Cayetano Heredia, corresponding author), Antonia Fuentes Herbozo (Universidad Peruana Cayetano Heredia, corresponding author), Laura K Beres (0000-0002-4731-7828, Johns Hopkins University, corresponding author), Lisa De Las Fuentes (0000-0002-4689-325X, Washington University in St. Louis, corresponding author), Lucy Cordova-Ascona (0000-0001-9262-9807, Universidad Peruana Cayetano Heredia, corresponding author), Zoila Vela-Clavo (0000-0002-8305-8085, Universidad Peruana Cayetano Heredia, corresponding author), Gonzalo Mariano Cuentas-Canal (0000-0002-5699-5030, EsSALUD, corresponding author), Juan Carlos Mendoza-Velasquez (Dirección Regional de Salud del Callao, corresponding author), Sonia Mercedes Paredes-Barriga (Dirección Regional de Salud del Callao, corresponding author), Raquel Hurtado La Rosa (Ministerio de Salud, corresponding author), Makeda J Williams (0000-0001-8896-4637, National Institutes of Health, corresponding author), Makeda Williams, Elvin Geng (0000-0002-0825-1424, Washington University in St. Louis, corresponding author), Elvin H Geng, William Checkley (0000-0003-1106-8812, Johns Hopkins University, corresponding author), J Gittelsohn (0000-0003-2761-3280, Johns Hopkins University, corresponding author), Victor G Davila-Roman, Víctor G Dávila‐Román (Washington University in St. Louis, corresponding author), Stella M Hartinger (0000-0003-3523-1725, Universidad Peruana Cayetano Heredia, corresponding author), Stella M Hartinger-Pena
EditorsHannah Hogan Leslie
Year2024
Volume4
Issue8
Pagese0002404
Publication date2024-08-19
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0002404
PMID39159182
OpenAlexW4401692772
LanguageEN
Citations received4
References cited22

Traditional patient- and provider-level hypertension interventions have proven insufficient to halt hypertension as the leading cause of morbidity and mortality globally. Systems-level interventions are required to address factors challenging hypertension control across a social ecological framework, an under-studied topic particularly salient in low- and middle-income countries (LMICs) such as Peru. To inform such interventions, we sought to identify key health systems barriers to hypertension care in Puno, Peru. A participatory stakeholder workshop (October 2021) and 21 in-depth interviews (October 2021—March 2022) were conducted with 55 healthcare professionals (i.e., doctors, nurses, midwives, dentists, nutritionists), followed by a deductive qualitative analysis of transcripts and notes. Participating healthcare providers indicated that low prioritization and lack of national policies for hypertension care have resulted in limited funding and lack of societal-level prevention efforts. Additionally, limited cultural consideration, both in national guidelines as well as by some providers in Puno, results in inadequate care that may not align with local traditions. Providers highlighted that patient care is also hampered by inadequate distribution and occasional shortages of medications and equipment, as well as a lack of personnel and limited opportunities for training in hypertension. Multiple incompatible health information systems, complicated referral systems, and geographic barriers additionally hinder continuity of care and care seeking. Insights gained from health providers on the healthcare system in Puno provide essential contextual information to inform development of organizational-level strategies necessary to improve provider and patient behaviors to achieve better hypertension care outcomes

Business · Organizational change · Political science · Public relations · Blood Pressure and Hypertension Studies · Global Public Health Policies and Epidemiology · Health Systems, Economic Evaluations, Quality of Life · Medicine · Nursing

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Unique citing works4
Citations per year4
Citation span2025 - 2026 (2)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 4
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