Low utilization of health care services following screening for hypertension in Dar es Salaam (Tanzania): a prospective population-based study.

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Version: Final published version
Serval ID
serval:BIB_EC1B00C016E5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Low utilization of health care services following screening for hypertension in Dar es Salaam (Tanzania): a prospective population-based study.
Journal
BMC Public Health
Author(s)
Bovet P., Gervasoni J.P., Mkamba M., Balampama M., Lengeler C., Paccaud F.
ISSN
1471-2458
ISSN-L
1471-2458
Publication state
Published
Issued date
2008
Peer-reviewed
Oui
Volume
8
Pages
art. 407 [8 p.]
Language
english
Abstract
BACKGROUND: Drug therapy in high-risk individuals has been advocated as an important strategy to reduce cardiovascular disease in low income countries. We determined, in a low-income urban population, the proportion of persons who utilized health services after having been diagnosed as hypertensive and advised to seek health care for further hypertension management. METHODS: A population-based survey of 9254 persons aged 25-64 years was conducted in Dar es Salaam. Among the 540 persons with high blood pressure (defined here as BP >or= 160/95 mmHg) at the initial contact, 253 (47%) had high BP on a 4th visit 45 days later. Among them, 208 were untreated and advised to attend health care in a health center of their choice for further management of their hypertension. One year later, 161 were seen again and asked about their use of health services during the interval. RESULTS: Among the 161 hypertensive persons advised to seek health care, 34% reported to have attended a formal health care provider during the 12-month interval (63% public facility; 30% private; 7% both). Antihypertensive treatment was taken by 34% at some point of time (suggesting poor uptake of health services) and 3% at the end of the 12-month follow-up (suggesting poor long-term compliance). Health services utilization tended to be associated with older age, previous history of high BP, being overweight and non-smoking, but not with education or wealth. Lack of symptoms and cost of treatment were the reasons reported most often for not attending health care. CONCLUSION: Low utilization of health services after hypertension screening suggests a small impact of a patient-centered screen-and-treat strategy in this low-income population. These findings emphasize the need to identify and address barriers to health care utilization for non-communicable diseases in this setting and, indirectly, the importance of public health measures for primary prevention of these diseases.
Keywords
Adult, Age Factors, Ambulatory Care, Community Health Centers, Continuity of Patient Care, Female, Health Care Surveys, Humans, Hypertension, Male, Mass Screening, Middle Aged, Outpatient Clinics, Hospital, Overweight, Patient Compliance, Poverty Areas, Preventive Health Services, Prospective Studies, Risk Factors, Smoking, Tanzania
Pubmed
Web of science
Open Access
Yes
Create date
18/03/2009 14:47
Last modification date
20/08/2019 16:14
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