LBPS 03-06 INCREASING UPTAKE OF HYPERTENSION SERVICES AMONG MALES AND ELDERLY IN AN URBAN INFORMAL SETTLEMENT IN KENYA

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Abstract

Objective:

The world is experiencing an epidemic of non-communicable diseases (NCDs). In Kenya, quarter of adults have raised blood pressure (BP) or are on medication for hypertension. Despite men having a higher prevalence of raised BP, 71% have never had their BP measured and 95% are not on treatment. Overall mean systolic BP is higher among men and increases with age. This study will compare effectiveness of four screening models; health facility, weekend, walkways and home-based in increasing uptake of hypertension services among males and elderly.

Design and Method:

A retrospectives cohort study was carried out targeting clients accessing hypertension services through four models between April 2015 and May 2016. Data was analysed for proportions. Chi square was used to determine significance in the differences. The differences were considered statistically significant when P < 0.05.

Results:

Of 107,303 reached with screening, home based reached the highest average number monthly at 7172 followed by health facilities at 2753. Overall, 16% of clients had raised BP with weekend and walkways having highest proportions at 20%, health facilities at 17% and home-based at 14%. The difference was statistically significant (p < 0.05). Walkway was most effective in reaching men at 53% followed by weekend (51%), home based (38%) and health facility (30%). The difference was statistically significant (p < 0.05). Weekend and walkway reached more clients > 40 years at 54% and 46% respectively while home-based and health facility reached least at 27% and 28% respectively. This difference was statistically significant.

Conclusions:

Despite high coverage of home based and health facility screening the population reached had lower risk. Walkway and weekend models are effective in reaching clients at risk such as males and elderly and should be integrated with health facilities to increase the impact and cost-effectiveness of hypertension programs in informal settlements.

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