What is already known on this topic? Hypertension is the most common cardiovascular disease in the world. If left uncontrolled, it can cause stroke, myocardial infarction, cardiac failure, renal failure, and hypertensive retinopathy. Diagnosis is the first step in managing and treating hypertension. The condition is highly undiagnosed in sub-Saharan Africa because screening programs are limited. What is added by this report?In Uganda, most primary health care facilities offer diagnostic services, but few have functioning diagnostic equipment, and refresher training is rarely available for health workers.What are the implications for public health practice? If diagnostic services are not available on a timely basis, the burden of hypertension will continue to increase in Uganda.

Objective: To determine the availability of hypertension diagnostic services, the readiness of health center IIs, health-facility associated factors, facilitators and the barriers in provision of hypertension diagnosis services. Design and method: A cross sectional study design was used, 79 health facilities were sampled randomly. Health facility checklists were administered to the health facility in-charges, individual semi-structured questionnaires to health workers and key informant interview guides to a purposive sample of health workers and personnel at Wakiso district. Chi-square and the Fisher's exact test were used to assess associations between categorical variables. Service availability was measured by assessing the provision of blood pressure (BP) measurements, weight measurements and the scheduling of regular check-ups. Readiness was measured by assessing the availability and functional status of the BP apparatus and other hypertension diagnostic equipment and supplies, and yet also the presence of a trained health care provider. Results: The majority (86%) of the primary care health facilities offered all the hypertension diagnosis services and 13% of the health centre IIs were ready to offer comprehensive hypertension diagnosis services. There were significant associations between the level of the health facility; BP measurements (P = 0.005), managing newly diagnosed cases of hypertension (P = 0.001), and scheduling of regular check-ups (P = 0.003). The health workers were facilitated by the availability of equipment, primary health care funds and implementing partners, whereas the barriers faced were the lack of equipment, availability of non-functional equipment, delays in receiving trainings’ and inadequate staffing. Conclusions: The study showed that the majority of the health facilities offered hypertension diagnosis services including the Health Centre IIs which are lowest in the tier. There were gaps in the readiness to offer hypertension diagnosis services, thus equipment should be routinely calibrated, replaced and routine continuous medical education sessions should be provided to the health workers.