Gufue Zenawi Hagos, Yimer Yimer Seid, Shentema Meaza Gezu, Zemelak Awgichew Kifle, Asfaw Zeytu Gashaw, Getachew Sefonias, Solomon Kalkidan, Tamire Mulugeta, Workneh Asmamaw Bezabeh, Aweke Girma Taye
Department of Public Health, College of Medicine and Health Sciences Adigrat University Adigrat Ethiopia.
Department of Epidemiology and Biostatistics, School of Public Health Addis Ababa University Addis Ababa Ethiopia.
Health Sci Rep. 2025 Jul 30;8(8):e71134. doi: 10.1002/hsr2.71134. eCollection 2025 Aug.
Hypertension is becoming a major public health issue in Ethiopia. However, there is limited comprehensive evidence on hypertension care, including service availability, utilization, and care quality. This study aimed to determine the effect of the NORAD-WHO-NCD intervention in improving the availability, utilization, and quality of hypertension care in public healthcare facilities.
A multicenter, quasi-experimental study comprising 31 interventions and 62 control public healthcare facilities was conducted across Ethiopia's six regions and one city administration between November 12 and December 31, 2023. A data abstraction form was used to collect relevant data spanning 54 months from various departments. To determine the independent effects of the intervention, a differences-in-difference regression model was used and < 0.05 was used to indicate statistical significance.
From 2019 to 2023, the percentage of healthcare facilities treating hypertension increased to 93.6% for intervention facilities and 90.3% for control facilities. The average monthly number of screenings performed in 2023 was 682 (95% CI 592, 772) among intervention and 278 (95% CI 238, 318) among control health facilities. In 2023, the average monthly number of newly diagnosed patients was 6 (95% CI 5, 7) by intervention and 4 (95% CI 3, 5) by control health facilities. Similarly, the average monthly number of patients receiving pharmacologic treatment was 138 (95% CI 103, 173) in intervention and 49 (95% CI 41, 57) in control facilities. In the intervention and control facilities, the average monthly number of patients with controlled blood pressure was 121 (95% CI 89, 154) and 49 (95% CI 40, 58), respectively. The intervention led to a monthly average increase of 425 hypertension screenings across all age groups (95% CI 131, 719, = 0.04).
While intervention facilities showed notable improvements, hypertension care services remain limited nationwide, underscoring the need for scalable interventions to address regional disparities.
高血压正成为埃塞俄比亚一个主要的公共卫生问题。然而，关于高血压护理，包括服务可及性、利用率和护理质量的全面证据有限。本研究旨在确定挪威发展合作署 - 世界卫生组织 - 非传染性疾病干预措施对改善公共医疗机构中高血压护理的可及性、利用率和质量的效果。
2023年11月12日至12月31日期间，在埃塞俄比亚的六个地区和一个市行政区开展了一项多中心、准实验性研究，包括31个干预性公共医疗机构和62个对照公共医疗机构。使用数据提取表从各个部门收集了跨越54个月的相关数据。为了确定干预措施的独立效果，使用了差分回归模型，P < 0.05表示具有统计学意义。
从2019年到2023年，治疗高血压的医疗机构比例在干预性机构中增至93.6%，在对照机构中增至90.3%。2023年，干预性医疗机构每月平均筛查次数为682次（95%置信区间592, 772），对照医疗机构为278次（95%置信区间238, 318）。2023年，干预性医疗机构每月新诊断患者的平均数量为6例（95%置信区间5, 7），对照医疗机构为4例（95%置信区间3, 5）。同样，干预性医疗机构每月接受药物治疗的患者平均数量为138例（95%置信区间103, 173），对照医疗机构为49例（95%置信区间41, 57）。在干预性和对照医疗机构中，血压得到控制的患者每月平均数量分别为121例（95%置信区间89, 154）和49例（95%置信区间40, 58）。该干预措施使所有年龄组每月高血压筛查平均增加425次（95%置信区间131, 719，P = 0.04）。
虽然干预性机构有显著改善，但全国范围内高血压护理服务仍然有限，这突出表明需要采取可扩展的干预措施来解决地区差异。
