Cargando…

Enablers and barriers for implementing high-quality hypertension care in a rural primary care setting in Nigeria: perspectives of primary care staff and health insurance managers

BACKGROUND: Hypertension is a highly prevalent risk factor for cardiovascular diseases in sub-Saharan Africa (SSA) that can be modified through timely and long-term treatment in primary care. OBJECTIVE: We explored perspectives of primary care staff and health insurance managers on enablers and barr...

Descripción completa

Detalles Bibliográficos
Autores principales: Odusola, Aina O., Stronks, Karien, Hendriks, Marleen E., Schultsz, Constance, Akande, Tanimola, Osibogun, Akin, van Weert, Henk, Haafkens, Joke A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Co-Action Publishing 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754020/
https://www.ncbi.nlm.nih.gov/pubmed/26880152
http://dx.doi.org/10.3402/gha.v9.29041
_version_ 1782415962216071168
author Odusola, Aina O.
Stronks, Karien
Hendriks, Marleen E.
Schultsz, Constance
Akande, Tanimola
Osibogun, Akin
van Weert, Henk
Haafkens, Joke A.
author_facet Odusola, Aina O.
Stronks, Karien
Hendriks, Marleen E.
Schultsz, Constance
Akande, Tanimola
Osibogun, Akin
van Weert, Henk
Haafkens, Joke A.
author_sort Odusola, Aina O.
collection PubMed
description BACKGROUND: Hypertension is a highly prevalent risk factor for cardiovascular diseases in sub-Saharan Africa (SSA) that can be modified through timely and long-term treatment in primary care. OBJECTIVE: We explored perspectives of primary care staff and health insurance managers on enablers and barriers for implementing high-quality hypertension care, in the context of a community-based health insurance programme in rural Nigeria. DESIGN: Qualitative study using semi-structured individual interviews with primary care staff (n = 11) and health insurance managers (n=4). Data were analysed using standard qualitative techniques. RESULTS: Both stakeholder groups perceived health insurance as an important facilitator for implementing high-quality hypertension care because it covered costs of care for patients and provided essential resources and incentives to clinics: guidelines, staff training, medications, and diagnostic equipment. Perceived inhibitors included the following: high staff workload; administrative challenges at facilities; discordance between healthcare provider and insurer on how health insurance and provider payment methods work; and insufficient fit between some guideline recommendations and tools for patient education and characteristics/needs of the local patient population. Perceived strategies to address inhibitors included the following: task-shifting; adequate provider payment benchmarking; good provider–insurer relationships; automated administration systems; and tailoring guidelines/patient education. CONCLUSIONS: By providing insights into perspectives of primary care providers and health insurance managers, this study offers information on potential strategies for implementing high-quality hypertension care for insured patients in SSA.
format Online
Article
Text
id pubmed-4754020
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Co-Action Publishing
record_format MEDLINE/PubMed
spelling pubmed-47540202016-03-08 Enablers and barriers for implementing high-quality hypertension care in a rural primary care setting in Nigeria: perspectives of primary care staff and health insurance managers Odusola, Aina O. Stronks, Karien Hendriks, Marleen E. Schultsz, Constance Akande, Tanimola Osibogun, Akin van Weert, Henk Haafkens, Joke A. Glob Health Action Original Article BACKGROUND: Hypertension is a highly prevalent risk factor for cardiovascular diseases in sub-Saharan Africa (SSA) that can be modified through timely and long-term treatment in primary care. OBJECTIVE: We explored perspectives of primary care staff and health insurance managers on enablers and barriers for implementing high-quality hypertension care, in the context of a community-based health insurance programme in rural Nigeria. DESIGN: Qualitative study using semi-structured individual interviews with primary care staff (n = 11) and health insurance managers (n=4). Data were analysed using standard qualitative techniques. RESULTS: Both stakeholder groups perceived health insurance as an important facilitator for implementing high-quality hypertension care because it covered costs of care for patients and provided essential resources and incentives to clinics: guidelines, staff training, medications, and diagnostic equipment. Perceived inhibitors included the following: high staff workload; administrative challenges at facilities; discordance between healthcare provider and insurer on how health insurance and provider payment methods work; and insufficient fit between some guideline recommendations and tools for patient education and characteristics/needs of the local patient population. Perceived strategies to address inhibitors included the following: task-shifting; adequate provider payment benchmarking; good provider–insurer relationships; automated administration systems; and tailoring guidelines/patient education. CONCLUSIONS: By providing insights into perspectives of primary care providers and health insurance managers, this study offers information on potential strategies for implementing high-quality hypertension care for insured patients in SSA. Co-Action Publishing 2016-02-12 /pmc/articles/PMC4754020/ /pubmed/26880152 http://dx.doi.org/10.3402/gha.v9.29041 Text en © 2016 Aina O. Odusola et al. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.
spellingShingle Original Article
Odusola, Aina O.
Stronks, Karien
Hendriks, Marleen E.
Schultsz, Constance
Akande, Tanimola
Osibogun, Akin
van Weert, Henk
Haafkens, Joke A.
Enablers and barriers for implementing high-quality hypertension care in a rural primary care setting in Nigeria: perspectives of primary care staff and health insurance managers
title Enablers and barriers for implementing high-quality hypertension care in a rural primary care setting in Nigeria: perspectives of primary care staff and health insurance managers
title_full Enablers and barriers for implementing high-quality hypertension care in a rural primary care setting in Nigeria: perspectives of primary care staff and health insurance managers
title_fullStr Enablers and barriers for implementing high-quality hypertension care in a rural primary care setting in Nigeria: perspectives of primary care staff and health insurance managers
title_full_unstemmed Enablers and barriers for implementing high-quality hypertension care in a rural primary care setting in Nigeria: perspectives of primary care staff and health insurance managers
title_short Enablers and barriers for implementing high-quality hypertension care in a rural primary care setting in Nigeria: perspectives of primary care staff and health insurance managers
title_sort enablers and barriers for implementing high-quality hypertension care in a rural primary care setting in nigeria: perspectives of primary care staff and health insurance managers
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754020/
https://www.ncbi.nlm.nih.gov/pubmed/26880152
http://dx.doi.org/10.3402/gha.v9.29041
work_keys_str_mv AT odusolaainao enablersandbarriersforimplementinghighqualityhypertensioncareinaruralprimarycaresettinginnigeriaperspectivesofprimarycarestaffandhealthinsurancemanagers
AT stronkskarien enablersandbarriersforimplementinghighqualityhypertensioncareinaruralprimarycaresettinginnigeriaperspectivesofprimarycarestaffandhealthinsurancemanagers
AT hendriksmarleene enablersandbarriersforimplementinghighqualityhypertensioncareinaruralprimarycaresettinginnigeriaperspectivesofprimarycarestaffandhealthinsurancemanagers
AT schultszconstance enablersandbarriersforimplementinghighqualityhypertensioncareinaruralprimarycaresettinginnigeriaperspectivesofprimarycarestaffandhealthinsurancemanagers
AT akandetanimola enablersandbarriersforimplementinghighqualityhypertensioncareinaruralprimarycaresettinginnigeriaperspectivesofprimarycarestaffandhealthinsurancemanagers
AT osibogunakin enablersandbarriersforimplementinghighqualityhypertensioncareinaruralprimarycaresettinginnigeriaperspectivesofprimarycarestaffandhealthinsurancemanagers
AT vanweerthenk enablersandbarriersforimplementinghighqualityhypertensioncareinaruralprimarycaresettinginnigeriaperspectivesofprimarycarestaffandhealthinsurancemanagers
AT haafkensjokea enablersandbarriersforimplementinghighqualityhypertensioncareinaruralprimarycaresettinginnigeriaperspectivesofprimarycarestaffandhealthinsurancemanagers