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A Narrative Synthesis of the Health Systems Factors Influencing Optimal Hypertension Control in Sub-Saharan Africa

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  • Juliet Iwelunmor
  • Jacob Plange-Rhule
  • Collins O Airhihenbuwa
  • Chizoba Ezepue
  • Olugbenga Ogedegbe

Abstract

Introduction: In sub-Saharan Africa (SSA), an estimated 74.7 million individuals are hypertensive. Reducing the growing burden of hypertension in sub-Saharan Africa will require a variety of strategies one of which is identifying the extent to which actions originating at the health systems level improves optimal management and control. Methods and Results: We conducted a narrative synthesis of available papers examining health systems factors influencing optimal hypertension in SSA. Eligible studies included those that analyzed the impact of health systems on hypertension awareness, treatment, control and medication adherence. Twenty-five articles met the inclusion criteria and the narrative synthesis identified the following themes: 1) how physical resources influence mechanisms supportive of optimal hypertension control; 2) the role of human resources with enabling and/or inhibiting hypertension control goals; 3) the availability and/or use of intellectual resources; 4) how health systems financing facilitate and/or compromise access to products necessary for optimal hypertension control. Conclusion: The findings highlight the need for further research on the health systems factors that influence management and control of hypertension in the region.

Suggested Citation

  • Juliet Iwelunmor & Jacob Plange-Rhule & Collins O Airhihenbuwa & Chizoba Ezepue & Olugbenga Ogedegbe, 2015. "A Narrative Synthesis of the Health Systems Factors Influencing Optimal Hypertension Control in Sub-Saharan Africa," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-17, July.
  • Handle: RePEc:plo:pone00:0130193
    DOI: 10.1371/journal.pone.0130193
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    References listed on IDEAS

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    1. Julio Frenk, 2010. "The Global Health System: Strengthening National Health Systems as the Next Step for Global Progress," PLOS Medicine, Public Library of Science, vol. 7(1), pages 1-3, January.
    2. Will Maimaris & Jared Paty & Pablo Perel & Helena Legido-Quigley & Dina Balabanova & Robby Nieuwlaat & Martin Mckee, 2013. "The Influence of Health Systems on Hypertension Awareness, Treatment, and Control: A Systematic Literature Review," PLOS Medicine, Public Library of Science, vol. 10(7), pages 1-18, July.
    3. Jayne Webster & Kassoum Kayentao & Samba Diarra & Sory I Diawara & Alhassane Ag Haiballa & Ogobara K Doumbo & Jenny Hill, 2013. "A Qualitative Health Systems Effectiveness Analysis of the Prevention of Malaria in Pregnancy with Intermittent Preventive Treatment and Insecticide Treated Nets in Mali," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-12, July.
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    1. Akosua A Wamba & Noah F Takah & Cathy Johnman, 2019. "The impact of interventions for the primary prevention of hypertension in Sub-Saharan Africa: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-16, July.

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