Literacy and motivation for the prevention and control of hypertension among female community health volunteers: a qualitative study from Nepal

Abstract

BackgroundThe prevalence of hypertension is increasing in Nepal. Thus, there is a need for a programme to improve primary healthcare. One possibility is to assign prevention, diagnosis, and treatment of hypertension to female community health volunteers (FCHVs).ObjectiveTo assess literacy and motivation to be involved in a hypertension prevention and control programme in Nepal among FCHVs.DesignFive focus group discussions (FGDs) were conducted with a total of 69 FCHVs in Lekhnath municipality, Kaski district, Nepal. Seven themes were developed on the basis of data collection: 1) knowledge about hypertension; 2) risk factors of hypertension; 3) prevention and control of hypertension; 4) access to treatment for hypertension in the community; 5) learning about blood pressure measurement; 6) ability to raise blood pressure awareness in the community; 7) possible challenges for their future involvement. Data were analysed using the thematic analysis approach.ResultsFCHVs have some knowledge about diagnosis, risk factors, and complications of hypertension. General unanimity was observed in the understanding that hypertension and risk factors needed to be addressed. The willingness of FCHVs to contribute to prevention, control, and management was strong, and they were confident that with some basic training they could obtain skills in hypertension management.ConclusionsDespite limited knowledge about hypertension, FCHVs expressed willingness and readiness to be trained in hypertension management. This study supports the possibility of involving FCHVs in prevention and control of hypertension in Nepal.

Hypertension Care Coordination and Feasibility of Involving Female Community Health Volunteers in Hypertension Management in Kavre District, Nepal: A Qualitative Study

“…Experience from India sets a template for designing a stepwise training and effective supervision mechanism for CHWs with little formal education in hypertension screening and management [ 27 ]. Similar to the findings of Neupane et al, despite having very limited knowledge about hypertension, FCHVs in our study were enthusiastic about learning more and confident in their ability to manage HTN in the community with proper training [ 28 ]. While FCHVs were eager to learn more about HTN management, they stressed the importance of external motivators and compensation in order to sustain a community-based hypertension intervention.…”

Community-based intervention for cervical cancer screening uptake in a semi-urban area of Pokhara Metropolitan, Nepal (COBIN-C): study protocol for a cluster-randomized controlled trial

“…In our study, FCHV in the intervention group will make three home visits to educate and empower women for cervical cancer screening uptake that is available free of cost at the local health facilities. Previous study reveals that appropriate and structured training program motivates FCHVs to contribute in addressing non-communicable diseases [ 14 ].…”

“…Studies suggest that mobilizing lay health workers and empowering them with integrated training could contribute in expansion of the knowledge base on non-communicable diseases (NCDs) at the community level and harmonize the community-based interventions [11][12][13]. In Nepal, female community health volunteers (FCHVs) have carried out community-based public health initiatives for more than 25 years and are willing to contribute to help mitigate NCDs [14]. FCHVs, a category of community health workers in Nepal, are married women, locally selected and trained through the Ministry of Health and Population.…”

Community-based intervention for blood pressure reduction in Nepal (COBIN trial): study protocol for a cluster-randomized controlled trial

“…The initial service to be promoted in the present trial design is for the FCHV to be skilled in monitoring blood pressure, providing health promotion counseling, and referring at-risk patients to the nearest health center for hypertension treatment. In our earlier feasibility study, FCHVs expressed willingness and readiness to be trained in hypertension management [ 21 ]. The FCHVs serve as a unique link between the health facilities and local communities, and they have the potential to play an important role in promoting knowledge and awareness of healthier lifestyles and thereby reducing the risk of hypertension.…”