| Title: |
Exploring contextual factors influencing the implementation of evidence-based care for hypertension in Rwanda : a cross-sectional study using the COACH questionnaire |
| Authors: |
Baumann, Ana A.; Hooley, Cole; Goss, Charles W.; Mutabazi, Vincent; Brown, Angela L.; Schechtman, Kenneth B.; Twagirumukiza, Marc; de las Fuentes, Lisa; Reeds, Dominic; Williams, Makeda; Mutimura, Eugene; Bergström, Anna; Nishimwe, Aurore; Ingabire, Cecile; Davila-Roman, Victor G. |
| Publisher Information: |
Uppsala universitet, Global hälsa - implementering och hållbarhet; Washington Univ, Brown Sch Social Work, St Louis, MO 63110 USA.; Brigham Young Univ, Sch Social Work, Provo, UT 84602 USA.; Washington Univ, Div Biostat, St Louis, MO 63110 USA.; Reg Alliance Sustainable Dev, Kigali, Rwanda.; Washington Univ, Dept Med, Cardiovasc Div, St Louis, MO 63130 USA.; Reg Alliance Sustainable Dev, Kigali, Rwanda.;Univ Rwanda, Coll Med & Hlth Sci, Kigali, Rwanda.; Washington Univ, Div Biostat, St Louis, MO 63110 USA.;Washington Univ, Sch Med, Dept Med, Cardiovasc Div, St Louis, MO 63110 USA.; Ctr Human Nutr, Dept Med, Div Geriatr & Nutr Sci, St Louis, MO USA.; NHLBI, Bldg 10, Bethesda, MD 20892 USA.; Reg Alliance Sustainable Dev, Kigali, Rwanda.;Natl Council Sci & Technol, Kigali, Rwanda.;Reg Alliance Sustainable Dev, Kigali, Rwanda.; BMJ |
| Publication Year: |
2021 |
| Collection: |
Uppsala University: Publications (DiVA) |
| Subject Terms: |
hypertension; education & training (see medical education & training); quality in healthcare; Health Care Service and Management; Health Policy and Services and Health Economy; Hälso- och sjukvårdsorganisation; hälsopolitik och hälsoekonomi; Public Health; Global Health; Social Medicine and Epidemiology; Folkhälsovetenskap; global hälsa; socialmedicin och epidemiologi |
| Description: |
Importance Hypertension is the largest contributor to the Global Burden of Disease. In Rwanda, as in most low-income and middle-income countries, an increasing prevalence of hypertension and its associated morbidity and mortality is causing major healthcare and economic impact. Understanding healthcare systems context in hypertension care is necessary. Objective To study the hypertension healthcare context as perceived by healthcare providers using the Context Assessment for Community Health (COACH) tool. Design A cross-sectional cohort responded to the COACH questionnaire and a survey about hypertension training. Setting Three tertiary care hospitals in Rwanda. Participants Healthcare professionals (n=223). Primary outcome(s) and measure(s) The COACH tool consists of 49 items with eight subscales: resources, community engagement, commitment to work, informal payment, leadership, work culture, monitoring services for action (5-point Likert Scale) and sources of knowledge (on a 0-1 scale). Four questions surveyed training on hypertension. Results Responders (n=223, 75% women; 56% aged 20-35 years) included nurses (n=142, 64%, midwives (n=42, 19%), primary care physicians (n=28, 13%) and physician specialists (n=11, 5%)). The subscales commitment to work, leadership, work culture and informal payment scored between 4.7 and 4.1 and the community engagement, monitoring services for action and organizational resources scored between 3.1 and 3.5. Sources of knowledge had a mean score of 0.6 +/- 0.3. While 73% reported having attended a didactic hypertension seminar in the past year, only 28% had received long-term training and 51% had |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
BMJ Open, 2021, 11:9; PMID 34548353; ISI:000698451400034 |
| DOI: |
10.1136/bmjopen-2020-048425 |
| Availability: |
http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-457479; https://doi.org/10.1136/bmjopen-2020-048425 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.BFCC18E3 |
| Database: |
BASE |