Hypertension management in rural primary care facilities in Zambia: a mixed methods study
Open accessAbstract
BACKGROUND: Improved primary health care is needed in developing countries to effectively manage the growing burden of hypertension. Our objective was to evaluate hypertension management in Zambian rural primary care clinics using process and outcome indicators to assess the screening, monitoring, treatment and control of high blood pressure. METHODS: Better Health Outcomes through Mentoring and Assessment (BHOMA) is a 5-year, randomized stepped-wedge trial of improved clinical service delivery underway in 46 rural Zambian clinics. Clinical data were collected as part of routine patient care from an electronic medical record system, and reviewed for site performance over time according to hypertension related indicators: screening (blood pressure measurement), management (recorded diagnosis, physical exam or urinalysis), treatment (on medication), and control. Quantitative data was used to develop guides for qualitative in-depth interviews, conducted with health care providers at a proportional sample of half (20) of clinics. Qualitative data was iteratively analyzed for thematic content. RESULTS: From January 2011 to December 2014, 318,380 visits to 46 primary care clinics by adults aged ≥ 25 years with blood pressure measurements were included. Blood pressure measurement at vital sign screening was initially high at 89.1% overall (range: 70.1-100%), but decreased to 62.1% (range: 0-100%) by 48 months after intervention start. The majority of hypertensive patients made only one visit to the clinics (57.8%). Out of 9022 patients with at least two visits with an elevated blood pressure, only 49.3% had a chart recorded hypertension diagnosis. Process indicators for monitoring hypertension were <10% and did not improve with time. In in-depth interviews, antihypertensive medication shortages were common, with 15/20 clinics reporting hydrochlorothiazide-amiloride stockouts. Principal challenges in hypertension management included 1) equipment and personnel shortages, 2) provider belief that multiple visits were needed before official management, 3) medication stock-outs, leading to improper prescriptions and 4) poor patient visit attendance. CONCLUSIONS: Our findings suggest that numerous barriers stand in the way of hypertension diagnosis and management in Zambian primary health facilities. Future work should focus on performance indicator development and validation in low resource contexts, to facilitate regular and systematic data review to improve patient outcomes. TRIAL REGISTRATION: ClinicalTrials.gov, Identifier NCT01942278 . Date of Registration: September 2013.
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Yan et al. 2017 was designed as a randomized stepped-wedge trial.
“The study was designed as a randomized stepped-wedge trial.”
From Applications and implementation considerations for stepped-wedge designs in sub-Saharan Africa: a systematic review (2026) · cites this paper as [79]
The Methods (Study setting and design) identify BHOMA, the programme whose clinic data this paper analyzes, as a randomized stepped-wedge trial. They describe the hypertension management study itself as using an explanatory sequential design with quantitative analysis followed by a qualitative component. The claim conflates the parent trial’s design with this study’s design. (LLM, conf=0.87)
Experimental — accuracy not yet measuredThe stepped-wedge design in Yan et al. 2017 helps in evaluating the impact of the intervention while ensuring all clinics eventually receive it.
“This design helps in evaluating the impact of the intervention while ensuring all clinics eventually receive it.”
From Applications and implementation considerations for stepped-wedge designs in sub-Saharan Africa: a systematic review (2026) · cites this paper as [79]
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Cites
Global status report on noncommunicable diseases 2010.
Alwan, A. (2011) · Cited by 8,494 · see citing works
Evaluating the quality of medical care
DONABEDIAN, A. (2005) · The Milbank Quarterly · doi:10.1111/j.1468-0009.2005.00397.x · Cited by 6,102 · see citing works
Donabedian, A. (1988) · JAMA · doi:10.1001/jama.260.12.1743 · Cited by 5,895 · see citing works
Evaluating the Quality of Medical Care
Donabedian, A. (1966) · The Milbank Memorial Fund Quarterly · doi:10.2307/3348969 · Cited by 4,418 · see citing works
Managing Clinical Knowledge for Health Care Improvement
Balas, E. A., & Boren, S. A. (2000) · Yearbook of Medical Informatics · doi:10.1055/s-0038-1637943 · Cited by 1,479 · see citing works
Research methods used in developing and applying quality indicators in primary care
Campbell, S., Braspenning, J., Hutchinson, A., & Marshall, M. (2003) · BMJ · doi:10.1136/bmj.326.7393.816 · Cited by 725 · see citing works
Effects of Pay for Performance on the Quality of Primary Care in England
Campbell, S., Reeves, D., Kontopantelis, E., Sibbald, B., & Roland, M. O. (2009) · New England Journal of Medicine · doi:10.1056/nejmsa0807651 · Cited by 695 · see citing works
Research methods used in developing and applying quality indicators in primary care
Campbell, S. (2002) · BMJ Quality & Safety · doi:10.1136/qhc.11.4.358 · Cited by 689 · see citing works
Beaglehole, R., Epping-Jordan, J., Patel, V., Chopra, M., Ebrahim, S., Kidd, M., & Haines, A. (2008) · The Lancet · doi:10.1016/s0140-6736(08)61404-x · Cited by 684 · see citing works
Clinical Practice Guidelines for the Management of Hypertension in the Community
Weber, M. A., Schiffrin, E. L., White, W. B., Mann, S. J., Lindholm, L. H., Kenerson, J. G., Flack, J. M., Carter, B. L., Materson, B. J., Ram, C. V. S., et al. (2013) · Journal of Hypertension · doi:10.1097/hjh.0000000000000065 · Cited by 681 · see citing works
Basinga, P., Gertler, P., Binagwaho, A., Soucat, A. L. B., Sturdy, J. R., & Vermeersch, C. M. J. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60177-3 · Cited by 627 · see citing works
30 years after Alma-Ata: has primary health care worked in countries?
Rohde, J. E., Cousens, S. N., Chopra, M., Tangcharoensathien, V., Black, R. E., Bhutta, Z. A., & Lawn, J. E. (2008) · The Lancet · doi:10.1016/s0140-6736(08)61405-1 · Cited by 285 · see citing works
Social Epidemiology of Hypertension in Middle-Income Countries
Basu, S., & Millett, C. J. (2013) · Hypertension · doi:10.1161/hypertensionaha.113.01374 · Cited by 267 · see citing works
Primary Care, Specialty Care, and Life Chances
Shi, L. (1994) · International Journal of Health Services · doi:10.2190/bduu-j0jd-bvex-n90b · Cited by 193 · see citing works
Pakenham-Walsh, N. M., & Bukachi, F. (2009) · Human Resources for Health · doi:10.1186/1478-4491-7-30 · Cited by 144 · see citing works
Performance indicators for primary care groups: an evidence based approach
McColl, A., Roderick, P., Gabbay, J., Smith, H. E., & Moore, M. V. (1998) · BMJ · doi:10.1136/bmj.317.7169.1354 · Cited by 135 · see citing works
Mendis, S., Johnston, S. C., Wu, F., Oladapo, O. O., Cameron, A., & Faramawi, M. F. (2009) · Bulletin of the World Health Organization · doi:10.2471/blt.08.062364 · Cited by 129 · see citing works
The Relationship Between Primary Care and Life Chances
Shi, L. (1992) · Journal of Health Care for the Poor and Underserved · doi:10.1353/hpu.2010.0460 · Cited by 121 · see citing works
Bovet, P., Gervasoni, J., Mkamba, M., Balampama, M. P., Lengeler, C., & Paccaud, F. M. (2008) · BMC Public Health · doi:10.1186/1471-2458-8-407 · Cited by 116 · see citing works
Stringer, J. S. A., Chisembele‐Taylor, A., Chibwesha, C. J., Chi, H. F., Ayles, H., Manda, H., Mazimba, W., Schuttner, L., Sindano, N., Williams, F. B., et al. (2013) · BMC Health Services Research · doi:10.1186/1472-6963-13-s2-s7 · Cited by 100 · see citing works
Self-citationQuality of care for hypertension in the United States
Asch, S. M., McGlynn, E. A., Hiatt, L., Adams, J., Hicks, J. A., DeCristofaro, A. H., Chen, R. K., Lapuerta, P., & Kerr, E. A. (2005) · BMC Cardiovascular Disorders · doi:10.1186/1471-2261-5-1 · Cited by 96 · see citing works
Developing Quality and Outcomes Framework (QOF) indicators and the concept of 'QOFability'.
Lester, H., & Campbell, S. (2010) · PubMed · Cited by 79 · see citing works
Campbell, S., Ludt, S., van Lieshout, J., Boffin, N., Wensing, M., Petek, D., Grol, R. P. T. M., & Roland, M. O. (2008) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1097/hjr.0b013e328302f44d · Cited by 78 · see citing works
Research needs for an improved primary care response to chronic non‐communicable diseases in Africa
Maher, D., Sekajugo, J., Harries, A. D., & Grosskurth, H. (2010) · Tropical Medicine & International Health · doi:10.1111/j.1365-3156.2009.02438.x · Cited by 57 · see citing works
Kabir, M., Iliyasu, Z., Abubakar, L., & Jibril, M. (2005) · Journal of Community Medicine and Primary Health Care · doi:10.4314/jcmphc.v16i1.32401 · Cited by 40 · see citing works
Quality indicators for cardiovascular primary care
Burge, F., Bower, K. N., Putnam, W., & Cox, J. L. (2007) · Canadian Journal of Cardiology · doi:10.1016/s0828-282x(07)70772-9 · Cited by 36 · see citing works
Paying Primary Health Care Centers for Performance in Rwanda
Basinga, P., Gertler, P., Binagwaho, A., Soucat, A. L. B., Sturdy, J. R., & Vermeersch, C. M. J. (2010) · doi:10.35648/20.500.12413/11781/ii202 · Cited by 36 · see citing works
Kim, Y. M., Chilila, M., Shasulwe, H., Banda, J., Kanjipite, W., Sarkar, S., Bazant, E., Hiner, C., Tholandi, M., Reinhardt, S., et al. (2013) · BMC Health Services Research · doi:10.1186/1472-6963-13-345 · Cited by 23 · see citing works
Flagged first, then by citations
1 of the 29 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
The impacts of medication shortages on patient outcomes: A scoping review
Phuong, J., Penm, J. H.-D., Chaar, B. B., Oldfield, L., & Moles, R. J. (2019) · PLoS ONE · doi:10.1371/journal.pone.0215837 · Cited by 261 · see citing works
Lall, D., Engel, N., Devadasan, N., Horstman, K., & Criel, B. (2018) · BMJ Global Health · doi:10.1136/bmjgh-2018-001077 · Cited by 102 · see citing works
Process evaluations of primary care interventions addressing chronic disease: a systematic review
Liu, H., Mohammed, A., Shanthosh, J., News, M., Laba, T., Hackett, M. L., Peiris, D., & Jan, S. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-025127 · Cited by 44 · see citing works
Bintabara, D., & Ngajilo, D. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-040908 · Cited by 45 · see citing works
Cultural beliefs and health-seeking practices: Rural Zambians' views on maternal-newborn care
Buser, J. M., Moyer, C. A., Boyd, C. J., Zulu, D. W., Ngoma-Hazemba, A., Mtenje, J. T., Jones, A. D., & Lori, J. R. (2020) · Midwifery · doi:10.1016/j.midw.2020.102686 · Cited by 30 · see citing works
Byiringiro, S., Ogungbe, O., Commodore-Mensah, Y. Y., Adeleye, K. K., Sarfo, F. S., & Himmelfarb, C. D. (2023) · PLOS Global Public Health · doi:10.1371/journal.pgph.0001794 · Cited by 22 · see citing works
Wroe, E. B., Mailosi, B. G. D., Price, N. F., Kachimanga, C., Shah, A., Kalanga, N., Dunbar, E. L., Nazimera, L., Gizaw, M., Boudreaux, C., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-063701 · Cited by 20 · see citing works
Interventions to improve primary healthcare in rural settings: A scoping review
Aubrey‐Bassler, K., Bursey, K., Pike, A. E., Penney, C., Furlong, B., Howells, M., Al-Obaid, H., Rourke, J. T. B., Asghari, S., & Hall, A. M. (2024) · PLoS ONE · doi:10.1371/journal.pone.0305516 · Cited by 22 · see citing works
Home Blood Pressure Monitoring by a Mobile-Based Model in Chongqing, China: A Feasibility Study
Xiao, M., Lei, X., Zhang, F., Sun, Z., Harris, V., Tang, X., & Yan, L. L. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16183325 · Cited by 17 · see citing works
Self-citationBauer, S., Mwanza, M. W., Chilengi, R., Holmes, C. B., Zyambo, Z., Furrer, H., Egger, M., Wandeler, G., & Vinikoor, M. J. (2017) · Global Health Action · doi:10.1080/16549716.2017.1359923 · Cited by 11 · see citing works
Self-citationBurger, R., Christian, C. S., Gerdtham, U., Haal, K., Hompashe, D. M., Smith, A., & Schutte, A. E. (2019) · Journal of Hypertension · doi:10.1097/hjh.0000000000002258 · Cited by 10 · see citing works
Povia, J. P., Masenga, S. K., Hamooya, B. M., & Gebremeskel, Y. (2023) · PLoS ONE · doi:10.1371/journal.pone.0295401 · Cited by 7 · see citing works
Shedul, G. L., Ripiye, N. R., Jamro-Comer, E., Orji, I. A., Shedul, G. J., Ugwuneji, E. N., Okpetu, E. I., Ale, B. M., Osagie, S., Baldridge, A. S., et al. (2025) · BMJ Open Quality · doi:10.1136/bmjoq-2024-003163 · Cited by 8 · see citing works
Chen, S., & Hall, E. A. H. (2020) · Electroanalysis · doi:10.1002/elan.202000032 · Cited by 7 · see citing works
Bosomprah, S., Bjonstad, E. C., Musuku, J., Siyumbwa, N., Ngandu, M., Chisunka, M., Banda, P., Goma, F. M., & Mweemba, A. (2023) · BMC Nephrology · doi:10.1186/s12882-023-03078-5 · Cited by 6 · see citing works
Self-citationEhteshami, F., Cassidy, R., Tediosi, F., Fink, G., & Muñoz, D. C. (2024) · Systems · doi:10.3390/systems12010016 · Cited by 5 · see citing works
Mutale, W., Ayles, H., Lewis, J. J., Bosompraph, S., Chilengi, R., Mwanamwenge, M. T., Sharp, A., Chintu, N., & Stringer, J. S. A. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1214066 · Cited by 5 · see citing works
Self-citationSauveur, R. S., Sufra, R., Pierre, M. C. J., Inddy, J., Jean, M., Mourra, N., Sundararajan, R. L., McNairy, M. L., Pape, J. W., Rouzier, V., et al. (2025) · BMC Public Health · doi:10.1186/s12889-024-20793-2 · Cited by 5 · see citing works
Self-citationWu, Y., Ye, R., Wang, Q., Sun, C., Sha, M., Sylvia, S., Zhou, H., Friesen, D., & Rozelle, S. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08179-9 · Cited by 5 · see citing works
Provider Perceptions about Hypertension: A Mixed Methods Study in Zambia
Spies, L. A., & Mulenga, J. (2020) · Clinical Nursing Research · doi:10.1177/1054773820904634 · Cited by 5 · see citing works
Israfil, I., Yusuf, A., Efendi, F., Making, M. A., & Agustini, N. L. P. I. B. (2024) · Healthcare in Low-resource Settings · doi:10.4081/hls.2024.11867 · Cited by 4 · see citing works
Cultural Practices, Knowledge, and Beliefs of Newborn Care and Health-Seeking in Rural Zambia
Buser, J. M. (2019) · Deep Blue (University of Michigan) · Cited by 4 · see citing works
Mwale, F., Ng’ambi, W. F., Zonda, J. M., Mfutso-Bengo, J. M., & Nkhoma, D. (2025) · International Journal of Noncommunicable Diseases · doi:10.4103/jncd.jncd_15_25 · Cited by 3 · see citing works
Besigye, I. K., Okuuny, V., Armstrong-Hough, M. J., Katahoire, A., Sewankambo, N. K., Mash, R. J., & Katamba, A. (2021) · South African Family Practice · doi:10.4102/safp.v63i1.5118 · Cited by 3 · see citing works
Marvi, A., Sadeghi, M., Aarabi, M., Shabanikiya, H., Kokabisaghi, F., Houshmand, E., & Najar, A. V. (2025) · Health Science Reports · doi:10.1002/hsr2.71444 · Cited by 3 · see citing works
Besigye, I. K., Okuuny, V., Armstrong-Hough, M. J., Katahoire, A., Sewankambo, N. K., Mash, R. J., & Katamba, A. (2020) · South African Family Practice · doi:10.4102/safp.v62i1.5118 · Cited by 2 · see citing works
Taher, A., Gondhowiardjo, S. A., Bachtiar, A., Prasetyo, S., Pixelyne, I., Huang, F., & Ahmad, R. S. (2022) · ASEAN Journal of Community Engagement · doi:10.7454/ajce.v6i1.1167 · Cited by 4 · see citing works
Yulianto, A. P., Adinda, N., Nasr, N. K., Fitriani, A., Kodriyah, K., Pramudita, I. R., Lestari, G. A., Agustin, H., Nabilah, H. H., & Kusumawardani, L. H. (2023) · Jurnal Inovasi Pengabdian dan Pemberdayaan Masyarakat · doi:10.54082/jippm.189 · Cited by 2 · see citing works
Murti, F. S., Josef, H. K., & Istiono, W. (2019) · Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) · doi:10.22146/rpcpe.46016 · Cited by 2 · see citing works
PELAYANAN KESEHATAN PADA LANSIA DENGAN HIPERTENSI DI TINGKAT PELAYANAN PRIMER: SYSTEMATIC REVIEW
Kurniawan, D., Rekawati, E., & Sahar, J. (2022) · Coping: Community of Publishing in Nursing · doi:10.24843/coping.2022.v10.i04.p11 · Cited by 3 · see citing works
Siame, L., Kabeta, M. B., Chama, G. C., Muchaili, L., Silumbwe, C. W., Hamooya, B. M., Mweene, B. C., Liweleya, S., Mulamfu, S., Povia, J. P., et al. (2025) · PLOS Global Public Health · doi:10.1371/journal.pgph.0004649 · Cited by 1 · see citing works
Rampamba, E. M., Campbell, S., Godman, B., & Meyer, J. C. (2025) · Healthcare · doi:10.3390/healthcare13192398 · Cited by 1 · see citing works
Mugisha, A. I., Uwishema, O., Bisetegn, L. D., Uwisanze, H., Fatokun, B. S., & Roy, S. (2026) · Tropical Medicine & International Health · doi:10.1111/tmi.70155 · Cited by 1 · see citing works
Bukola, O. O., Olagunju, O. O., & Theresa, M. N. (2020) · Journal of Hypertension and Management · doi:10.23937/2474-3690/1510051 · Cited by 1 · see citing works
Noncommunicable Disease Program for Blood Pressure Ontrol in Tamil Nadu, India
Kamaraj, P., Selvam, J. M., Sivalingam, A., Pal, P., Kasiviswanathan, S., Suresh, A., Selvavinayagam, T. S., & Kaur, P. (2022) · Journal of Public Health and Primary Care · doi:10.4103/jphpc.jphpc_4_22 · Cited by 1 · see citing works
Kusumawardani, L. H., Triyanto, E., & Iskandar, A. (2023) · Jurnal Abdi Masyarakat Indonesia · doi:10.54082/jamsi.987 · Cited by 1 · see citing works
Musa, Z. A., Akinsolu, F. T., Salako, A. O., Abodunrin, O. R., Ola, O. M., & Ezechi, O. C. (2026) · Frontiers in Epidemiology · doi:10.3389/fepid.2026.1529289
Byiringiro, S., Ogungbe, O., Commodore-Mensah, Y. Y., Adeleye, K. K., Sarfo, F. S., & Himmelfarb, C. D. (2022) · medRxiv · doi:10.1101/2022.10.19.22280830
Adeniran, A., Oluwole, E. O., Chieme, C. F., Ojo, O. Y., Ilesanmi, M. M., Olujobi, B. A., Ogundimu, O., & Durojaiye, T. O. (2023) · Journal of Public Health and Primary Care · doi:10.4103/jphpc.jphpc_34_22
Israfil, I., Yusuf, A., & Efendi, F. (2025) · Arterial’naya Gipertenziya (Arterial Hypertension) · doi:10.18705/1607-419x-2025-2363
Wu, Y., Ye, R., Wang, Q., Sun, C., Meng, S., Sylvia, S., Zhou, H., Friesen, D., & Rozelle, S. (2022) · Figshare · doi:10.6084/m9.figshare.20220251
Ogyu, A., Rouzier, V., Sufra, R., Sauveur, R. S., Celestin, K., Forestal, G. P. L., Préval, F., Marcelin, S. E., Auguste, S., Lee, M. H., et al. (2026) · Hypertension · doi:10.1161/hypertensionaha.125.26295
Self-citationZulu, R., Namayawa, S., Musonda, E., Mumba, P., Sikaluzwe, M., Henry, N. U., & Phiri, M. (2026) · Discover Public Health · doi:10.1186/s12982-026-02731-2
Shu, Y., Liu, T., Luo, J., Dai, P., & Cheng, H. (2026) · Critical Public Health · doi:10.1080/09581596.2026.2732651
Social Determinants of Hypertension: A Focus on Low- and Middle-Income Countries
Haddiya, I., Korbel, Z., Ramdani, S., & Haddiya, E. (2026) · Social medicine · doi:10.71164/socialmedicine.v19i3.2026.1967
- Authors
- Yan, L. D., Chirwa, C., Chi, B. H., Bosomprah, S., Sindano, N., Mwanza, M., Musatwe, D., Mulenga, M., & Chilengi, R.
- Affiliations
- Centre for Infectious Disease Research in Zambia (ZM)
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Yan, Lily D.
- Venue
- BMC Health Services Research
- Published
- 2017-02-03
- Volume
- 17
- Issue
- 1
- Pages
- 111-111
- ISSN
- 1472-6963 (ISSN-L)
- PMC
- PMC5292001
- OpenAlex
- W2583624004
- Cited by
- 46
- References
- 29
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 3 · 2023: 7 · 2022: 8 · 2021: 1 · 2020: 6 · 2019: 6 · 2018: 1 · 2017: 1
- FWCI
- 2.96
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- BMC Health Services Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- Funders
- Doris Duke Charitable Foundation (2009060)
- Comic Relief (146781)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Keywords
- antihypertensive therapy, rural primary care, blood pressure screening, hypertension diagnosis, vital signs monitoring, performance indicators, stepped-wedge cluster randomized trial, Zambia, resource-limited settings, electronic health records
- MeSH terms
- Adult, Antihypertensive Agents, Developing Countries, Female, Humans, Hypertension, Interviews as Topic, Male, Primary Health Care, Quality of Health Care, Zambia, Randomized Controlled Trials as Topic, Outcome Assessment, Health Care, Rural Health Services, Qualitative Research, Quality Improvement
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