Boima Vincent, Doku Alfred, Hayfron-Benjamin Charles, Twumasi Afua A A, Awuah Raphael Baffour, Selom Juliette Edzeame, van den Born Bert-Jan H, Agyemang Charles
Academic Medical Center, University of Amsterdam, Amsterdam, North Holland, The Netherlands
Medicine and Therapeutics, University of Ghana Medical School, Accra, Ghana.
BMJ Glob Health. 2025 Aug 26;10(8):e017511. doi: 10.1136/bmjgh-2024-017511.
Hypertension has a significant impact on healthcare systems in Sub-Saharan Africa. Despite Ghana's high prevalence of hypertension, health system barriers impede its detection, treatment and control. This study assessed the level of understanding and systemic barriers that influence hypertension detection, management and control. This qualitative study was conducted in coastal communities in the Greater Accra Region of Ghana between December 2023 and January 2024. Participants with hypertension, healthcare professionals and religious/traditional leaders were purposively selected to ensure a diverse representation of perspectives. A total of 14 focus group discussions (FGDs) and 56 in-depth interviews (IDIs) were conducted. All FGDs and IDIs were audio recorded, transcribed and analysed using the qualitative software package, Atlas.ti. The themes identified included lay description of hypertension, perceived causes/risks of hypertension, caregiving, knowledge on management and prevention, knowledge on complications of hypertension, impact of hypertension, challenges of living with hypertension and actions by faith-based organisations regarding hypertension and its management. Although patients hold positive views of support systems for hypertension management, financial restrictions, distance to healthcare and stigma hindered hypertension management. Residents in these coastal communities tend to understand hypertension, its management and its problems. The identified barriers for management of hypertension in these communities include financial and structural constraints. Despite these obstacles, these people understood the need for social support, as families, individuals and religious organisations help hypertensive patients financially and socially.
高血压对撒哈拉以南非洲的医疗系统有着重大影响。尽管加纳高血压患病率很高，但卫生系统的障碍阻碍了其检测、治疗和控制。本研究评估了影响高血压检测、管理和控制的理解水平和系统障碍。这项定性研究于2023年12月至2024年1月在加纳大阿克拉地区的沿海社区进行。有目的地选择了高血压患者、医疗保健专业人员和宗教/传统领袖，以确保观点的多样化代表性。总共进行了14次焦点小组讨论（FGD）和56次深入访谈（IDI）。所有FGD和IDI都进行了录音、转录，并使用定性软件包Atlas.ti进行分析。确定的主题包括对高血压的外行描述、高血压的感知原因/风险、护理、管理和预防知识、高血压并发症知识、高血压的影响、高血压患者的生活挑战以及基于信仰的组织在高血压及其管理方面的行动。尽管患者对高血压管理的支持系统持积极看法，但经济限制、就医距离和耻辱感阻碍了高血压管理。这些沿海社区的居民倾向于了解高血压、其管理及其问题。在这些社区中确定的高血压管理障碍包括经济和结构限制。尽管有这些障碍，但这些人理解社会支持的必要性，因为家庭、个人和宗教组织在经济和社会方面帮助高血压患者。
