Adherence to National Standard Treatment Guidelines in the management of hypertension and associated factors among healthcare providers at public district hospitals in Dar es Salaam, Tanzania

Bibliographic Data

ID22263884
AuthorsGasper Singfrid Mung’ong’o (0009-0005-0843-4676, Muhimbili University of Health and Allied Sciences, corresponding author), Daniel Msilanga (0009-0009-6109-0728, Muhimbili University of Health and Allied Sciences), Paul Alikado Sabuni (0009-0002-3169-2647, Catholic University of Health and Allied Sciences), Humphrey Godwin Medarakini (0009-0006-3318-7184, Muhimbili University of Health and Allied Sciences), Gladys Reuben Mahiti (Muhimbili University of Health and Allied Sciences), Rose Mpembeni (0000-0002-3916-2790, Muhimbili University of Health and Allied Sciences)
EditorsJulia Robinson (0000-0003-0719-3995)
Year2026
Volume6
Issue7
Pagese0005818
Publication date2026-07-09
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.0005818
PMID42424347
OpenAlexW7167850581
LanguageEN
References cited20

Hypertension affects 15–25% of adults in Tanzania, yet fewer than 30% of treated patients achieve blood pressure control. Poor control contributes to stroke, heart failure, and renal disease. The National Standard Treatment Guidelines (NSTGs), 6th edition (2021), provide guidance for management, but healthcare provider adherence to the guidelines remains unclear. A mixed-methods cross-sectional study was conducted at five public district hospitals in Dar es Salaam, Tanzania between 1 st April and 31 st May 2025. Quantitative data from patient records assessed healthcare provider adherence to pharmacological treatment, complication monitoring, and comorbidity screening, categorized as complete, partial, or non-adherent. Modified Poisson regression identified associated patient and provider factors. Qualitative data from 11 in-depth interviews were thematically analysed to explore barriers and facilitators to adherence. The median age of the 397 patients was 55 years (IQR: 52–61), 79.1% were female, 40.0% had at least one comorbidity, and 65.2% were overweight. Only 26.2% were managed with complete adherence to NSTGs. Higher adherence was associated with follow-up visits (aPR = 5.81; 95% CI: 1.59–21.27), Grade 1 hypertension (aPR = 3.87; 95% CI: 1.99–7.53), Grade 2 hypertension (aPR = 5.06; 95% CI: 1.52–16.73), comorbidities (aPR = 2.35; 95% CI: 1.25–4.41), specialist cadre (aPR = 7.00; 95% CI: 1.05–46.55), and provider experience of 5–10 years (aPR = 3.25; 95% CI: 1.17–9.03) and >10 years (aPR = 3.91; 95% CI: 1.20–12.73). Barriers included outdated guidelines, limited resources, staffing shortages, and inadequate training, while facilitators included mentorship, peer collaboration, accessible guidelines, and continuing medical education. Healthcare provider adherence to NSTGs in management of hypertension was low. Strengthening guideline implementation through updated recommendations, provider training, improved resource availability, and supportive supervision may enhance adherence and improve patient outcomes

Blood pressure · Comorbidity · Health care · Medical record · Poisson regression · Public health · Staffing · Tanzania · Blood Pressure and Hypertension Studies · Medication Adherence and Compliance · Mobile Health and mHealth Applications

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