Health systems performance for hypertension control using a cascade of care approach in South Africa, 2011–2017
Bibliographic Data
| ID | 19594491 |
|---|---|
| Authors | Mariet Benade (0000-0001-9498-3199, Boston University, corresponding author), Zandile June‐Rose Mchiza (0000-0003-2515-9184, South African Medical Research Council, corresponding author), Zandile Mchiza, Rafeya V Raquib (Boston University, corresponding author), Sridevi K Prasad (0000-0003-0457-9534, Boston University, corresponding author), Lily D Yan (0000-0001-6363-7920, Cornell University, corresponding author), Alana T Brennan (0000-0002-7746-0668, Boston University, corresponding author), Justine Ina Davies (0000-0001-6834-1838, University of Birmingham, corresponding author), Nikkil Sudharsanan (0000-0003-1710-4634, Heidelberg University, corresponding author), Jennifer Manne-Goehler (0000-0001-9295-0035, Massachusetts General Hospital, corresponding author), Matthew P Fox (0000-0002-5132-7818, Boston University, corresponding author), Joep Bor (0000-0002-5112-8536, Boston University, corresponding author), Stanley Rosen (0000-0002-6560-2964, Boston University, corresponding author), Sydney B Rosen, Andrew Stokes (0000-0002-8502-3636, Boston University, corresponding author) |
| Editors | Prashanth Nuggehalli Srinivas (0000-0003-0968-0826) |
| Year | 2023 |
| Volume | 3 |
| Issue | 9 |
| Pages | e0002055 |
| Publication date | 2023-09-07 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | PLOS Global Public Health (JOURNAL) |
| Journal identifiers | ISSN: 2767-3375 • E-ISSN: 2767-3375 |
| Publisher | Public Library of Science (PLoS) (PUBLISHER) |
| DOI | 10.1371/journal.pgph.0002055 |
| PMID | 37676845 |
| OpenAlex | W4386495651 |
| Language | EN |
| Citations received | 1 |
| References cited | 26 |
Hypertension is a major contributor to global morbidity and mortality. In South Africa, the government has employed a whole systems approach to address the growing burden of non-communicable diseases. We used a novel incident care cascade approach to measure changes in the South African health system’s ability to manage hypertension between 2011 and 2017. We used data from Waves 1–5 of the National Income Dynamics Study (NIDS) to estimate trends in the hypertension care cascade and unmet treatment need across four successive cohorts with incident hypertension. We used a negative binomial regression to identify factors that may predict higher rates of hypertension control, controlling for socio-demographic and healthcare factors. In 2011, 19.6% (95%CI 14.2, 26.2) of individuals with incident hypertension were diagnosed, 15.4% (95%CI 10.8, 21.4) were on treatment and 7.1% had controlled blood pressure. By 2017, the proportion of individuals with diagnosed incident hypertension had increased to 24.4% (95%CI 15.9, 35.4). Increases in treatment (23.3%, 95%CI 15.0, 34.3) and control (22.1%, 95%CI 14.1, 33.0) were also observed, translating to a decrease in unmet need for hypertension care from 92.9% in 2011 to 77.9% in 2017. Multivariable regression showed that participants with incident hypertension in 2017 were 3.01 (95%CI 1.77, 5.13) times more likely to have a controlled blood pressure compared to those in 2011. Our data show that while substantial improvements in the hypertension care cascade occurred between 2011 and 2017, a large burden of unmet need remains. The greatest losses in the incident hypertension care cascades came before diagnosis. Nevertheless, whole system programming will be needed to sufficiently address significant morbidity and mortality related to having an elevated blood pressure
Blood pressure · Health care · Blood Pressure and Hypertension Studies · Demography · Global Health Care Issues · Health Systems, Economic Evaluations, Quality of Life · Medicine · Emergency Medicine · Internal Medicine · Pediatrics
| Unique citing works | 1 |
|---|---|
| Citations per year | 1 |
| Citation span | 2025 - 2025 (1) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 1 |