The capacity of primary health care centers in Jordan to manage hypertension: areas for improvement

Abstract

The assessment of the capacity of Primary Health Care (PHC) settings for the management of hypertension is essential to identify areas for improving management outcomes. This study aimed to assess the capacity of PHC centers in Jordan to manage hypertension including the assessment of human resources, equipment, and infrastructure. All comprehensive PHC centers located in Irbid and Mafraq governorates in north of Jordan (n = 23) were assessed. An assessment tool from HEARTS Technical Package was adapted and used for assessment. All centers have general practitioners and half of the centers (n = 11, 47.8%) had at least one family doctor working full time. In only one center, all doctors, nurses, and other health workers were trained on the management of hypertension. All centers, except one, had at least one functional automatic blood pressure measuring devices (BPMDs). Almost two thirds of centers (43.5%) had no measuring tapes. ECG machines were present in all centers except two. One third (n = 8, 34.8%) of centers had no functional glucometers. The majority of health centres carry out the laboratory investigations. Educational materials on physical activity, hypertension, and diabetes were seen in four (17.4%) centers only. Necessary medications were always available in the majority of health centers. In conclusion, this assessment revealed many areas for improvement in human resources, equipment, infrastructures, and other resources, such as developing an updated guideline/protocol of hypertension management, training the PHC staff on these guidelines, providing PHC centers with the necessary equipment, and establishing e-registry to improve documentation of data.

Adaptation, implementation, and evaluation of the HEARTS technical package in primary health care settings in Jordan to improve the management of hypertension: a pilot study

“…In Jordan, the lack of updated national guidelines for the management of hypertension that provide up-todate information and facilitate the translation of new evidence into clinical practice contributes to the challenges in managing hypertension (11). Therefore, this study aimed to adapt, implement, and evaluate hypertension control following the implementation of the HEARTS Technical Package in six health centers in Jordan.…”

“…The low blood pressure control rate could also be explained by the Jordanian health system capacity and readiness for hypertension management. A recent assessment of 23 health centers in Jordan found poor availability of and training on evidence-based guidelines for hypertension in Jordan (11). Additionally, a recent unpublished study in Jordan showed that most NCDs management guidelines were outdated and did not re ect the best available evidence (17).…”

“…This may lead to inappropriate selection of antihypertensive medications by the physician as well as therapeutic inertia-de ned as the failure of the health care provider to initiate or intensify therapy when therapeutic goals are not met, which is considered a major cause of uncontrolled hypertension (18). There is also a shortage of equipment, commodities, and supplies, unavailability of diagnostic procedures, shortage of staff, and unavailability of an electronic system for patient medical information entry (11).…”

“…The HEARTS technical package has standardized the treatment protocol to control hypertension at the primary health care level which has positively impacted the quality of clinical care and variability (10). Before the implementation of the HEARTS technical package, an assessment of the 23 Comprehensive Health Centers (CHCs) revealed many areas for improvement in human resources, equipment, infrastructures, and other resources such as developing an updated guideline/protocol for hypertension management, training the PHC staff on these guidelines, providing PHC centers with the necessary equipment and establishing e-registry to improve documentation of data (11). The main objectives of this study were to adapt and implement the HEARTS technical package in health care centers in Irbid and Mafraq governorates and evaluate its effectiveness on hypertension management and control.…”

Leadership Practices as Perceived by Emergency Nurses During the COVID-19 Pandemic: The Role of Structural and Psychological Empowerment

“…Nurses are dealing with cases from different acuity levels, and all necessary resources (especially medications) are always available in most emergency departments. However, there is a lack of updated guidelines of emergency treatments and management ( Al-Hadeethi et al, 2022 ; Suleiman, Hijazi, Al Kalaldeh, & Sharour, 2019; Nusairat, 2006 ).…”