Evidence mapPaperPMID 40300032Full record

ArticlePLOS global public health2025

Barriers to and facilitators of linkage to care following hypertension and diabetes screening among health workers in Zimbabwe: A mixed method study.

Leyla Larsson, Rudo M S Chingono, Claire J Calderwood, Farirai P Nzvere, Edson T Marambire, Fungai Kavenga, Sibusisiwe Sibanda, Bridget Kanengoni, Nicol Redzo, Victoria Simms and 6 more

Abstract read
In one paragraph

Article in PLOS global public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Leyla LarssonInstitute of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany.ORCID https://orcid.org/0000-0003-4869-4630
Rudo M S ChingonoThe Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe.
Claire J CalderwoodThe Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe.
Farirai P NzvereThe Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe.ORCID https://orcid.org/0000-0002-3260-6889
Edson T MarambireInstitute of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany.ORCID https://orcid.org/0000-0001-5944-5010
Fungai KavengaThe Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe.
Sibusisiwe SibandaThe Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe.
Bridget KanengoniThe Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe.
Nicol RedzoThe Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe.
Victoria SimmsThe Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe.
Chiratidzo E NdhlovuInternal Medicine Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Hilda MujuruDepartment of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.ORCID https://orcid.org/0000-0003-1615-3856
Simbarashe RusakanikoFamily Medicine, Global and Public Health Unit, Faculty of Medicine and Health Sciences, Harare, Zimbabwe.ORCID https://orcid.org/0000-0002-3159-0205
Rashida A FerrandThe Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe.
Kalpana SabapathyDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom.ORCID https://orcid.org/0000-0001-8017-6716
Katharina KranzerInstitute of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The benefits of screening for any condition are only realised if individuals who screen positive link to care services. We investigated linkage to hypertension and diabetes care by healthcare workers accessing a comprehensive health check service. We also explored facilitators and barriers to linkage to care. Between July 2020 and June 2022, a health check with referral and follow-up was offered to healthcare workers (clients) in Zimbabwe. We aimed to understand the proportion that linked to care after referral for an elevated blood pressure and/or HbA1c, assessed by follow-up phone calls. Linkage to care was defined as self-report of having seen a health professional within 30-60 days of the positive screening test result. In-depth interviews were conducted with 15 clients to understand associated facilitators and barriers. Overall, 3,143 clients accessed screening services. The majority were women (75.7%), and median age was 37 (IQR: 28-46) years. 785 (25.0%) clients screened positive for hypertension and 279 (8.9%) screened positive for diabetes. Clients referred for diabetes were more likely to accept referral (n=212, 72.0%) than those referred for hypertension (n=323, 41.1%). Among those referred and successfully contacted for follow-up, 131/182 (72.0%) reported having linked to care for diabetes and 218/269 (81.0%) for hypertension. Distance, accessibility, and travel costs to the facility they were referred to, influenced the decision and ability to link to care. While linkage to care for hypertension and diabetes was high among those who accepted referral, many healthcare workers did not accept referral. Greater awareness among healthcare providers regarding the importance of NCD care to improve acceptance of referral is required and every step of the care cascade must be affordable, accessible, and patient-centred.

Identifiers

PMID40300032
PMCPMC12040240

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.