A socio-ecological framework examination of drivers of blood pressure control among patients with comorbidities and on treatment in two Nairobi slums; a qualitative study

Bibliographic Data

ID19594593
AuthorsShukri F Mohamed (0000-0002-8693-1943, University of Warwick, corresponding author), Teresia Macharia (0000-0003-3126-9988), Gershim Asiki (0000-0002-9966-1153, African Population and Health Research Center), Paramjit Gill (0000-0001-8756-6813, University of Warwick)
EditorsVijayaprasad Gopichandran (0000-0003-2635-9583)
Year2023
Volume3
Issue3
Pagese0001625
Publication date2023-03-10
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.0001625
PMID36963082
OpenAlexW4323832025
LanguageEN
Citations received3
References cited44

Despite the known and effective treatments to control blood pressure, there is limited information on why there are high uncontrolled hypertension rates in urban slum settings. The aim of this paper is to explore the views of treated people with uncontrolled hypertension and other key stakeholders on the facilitators and barriers to blood pressure control among people with comorbid conditions in two Nairobi slums. The study was conducted in two Nairobi slums namely, Korogocho and Viwandani. This study used a qualitative methodology using interviews and focus group discussions. Barriers and facilitators to blood pressure control were explored using the Social Ecological Model (SEM) framework. A total of 57 participants were interviewed for this study. There were 31 in-depth interviews and two focus group discussions among participants with uncontrolled hypertension and with comorbidities. Additionally, 16 key informant interviews were conducted with healthcare providers and decision/policymakers. All interviews were audio-recorded, transcribed verbatim and analysed thematically. This study identified barriers and facilitators to blood pressure control among patients with uncontrolled hypertension at the patient/individual level, family and community level, health system level and at the policy level. High cost of hypertension medicines, the constant unavailability of medicines at the health facilities, unsupportive family and environment, poor medicines supply chain management, availability and use of guidelines were among the barriers reported. The results show that uncontrolled hypertension is a major public health issue in slums of Nairobi and they highlight barriers to blood pressure control at different levels of the socio-ecological model. These findings can be used to design holistic interventions to improve blood pressure control by addressing factors operating at multiple levels of the socio-ecological framework

Blood pressure · Business · Economic growth · Environmental health · Family medicine · Focus group · Health care · Population · Qualitative research · Slum · Sociology · Unavailability · Blood Pressure and Hypertension Studies · Global Public Health Policies and Epidemiology · Health Systems, Economic Evaluations, Quality of Life · Medicine · Nursing