Evidence map›Paper›PMID 41140184›Full record

ArticleGlobal health action2025

Healthcare provider and health system leader perspectives on barriers to hypertension care in Malawi: insights from integrated and non-integrated HIV care settings.

Christine Hagstrom, Pericles Kalande, Anu Aryal, Khumbo Phiri, Joep J van Oosterhout, George Talama, Eric Lungu, Sam Phiri, Corrina Moucheraud, Risa Hoffman

Abstract read
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Article in Global health action, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Christine HagstromDepartment of Medicine, Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.ORCID 0000-0001-5459-4332
Pericles KalandeImplementation Science Department, Partners in Hope, Lilongwe, Malawi.ORCID 0009-0006-3651-200X
Anu AryalDepartment of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, CA, USA.ORCID 0000-0001-9649-8170
Khumbo PhiriImplementation Science Department, Partners in Hope, Lilongwe, Malawi.
Joep J van OosterhoutDepartment of Medicine, Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.ORCID 0000-0002-3441-0804
George TalamaImplementation Science Department, Partners in Hope, Lilongwe, Malawi.
Eric LunguImplementation Science Department, Partners in Hope, Lilongwe, Malawi.
Sam PhiriImplementation Science Department, Partners in Hope, Lilongwe, Malawi.
Corrina MoucheraudDepartment of Public Health Policy and Management, New York University School of Global Public Health, New York, NY, USA.ORCID 0000-0001-7862-7928
Risa HoffmanDepartment of Medicine, Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.ORCID 0000-0001-9575-4574

Funding

UCLA-CDU CFARP30AI152501 · NIAID · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI SCOTT G KITCHEN · 2022 to 2026
$15.6M
The Makonda Study: Preferences for hypertension care among adults in MalawiR21TW011691 · FIC · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI HOFFMAN, RISA M. · 2020 to 2021
$378k
FIC NIH HHS R21 TW011691NIAID NIH HHS P30 AI152501
6 · The paper itself

Abstract

backgroundMalawi has a significant burden of hypertension, including for people with HIV. The World Health Organization recommends integrated HIV-hypertension care, but such integration is not widely implemented in resource-constrained settings.

objectiveThis study explored barriers to hypertension care in Malawi from the perspectives of healthcare providers and health system leaders.

methodsWe conducted a qualitative study of providers and health system leaders across 14 health facilities in Malawi. Interviews explored hypertension services in integrated (HIV and hypertension) and non-integrated clinics to identify barriers to hypertension care and compare barriers by integration status. Interview guides and analysis used the Consolidated Framework for Implementation Research. All transcripts were double coded and thematic analysis was performed.

resultsFrom April-May 2023, we interviewed 33 individuals (25 providers and 8 health system leaders). Barriers to hypertension care were largely the same in integrated and non-integrated clinics and included stockouts of antihypertensive medications, lack of equipment, lack of provider training, and weak medical record systems. Providers working in integrated care emphasized the benefits of reduced burden for clients and improved quality of care but also reported unique challenges, including capacity constraints (due to the large number of clients) and inability to provide aligned dispensing of antihypertensive medications and ART (due to antihypertensive medication stockouts).

conclusionsBarriers to integrated HIV and hypertension care in our study largely reflected challenges for hypertension care more broadly. Future efforts should focus on provider training, supply chain strengthening, equipment procurement, and medical record system strengthening to improve outcomes for people with hypertension and hypertension-HIV multimorbidity.

Indexed as

Attitude of Health PersonnelDelivery of Health Care, IntegratedHealth PersonnelHealth Services AccessibilityHIV InfectionsHypertensionAdultAntihypertensive AgentsFemaleHumansInterviews as TopicMalawiMaleMiddle AgedQualitative ResearchAntihypertensive AgentsAfricaHIVintegrated caremultimorbiditynon-communicable diseases

Identifiers

PMID41140184
PMCPMC12570229

What Socratic holds

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LicenceCC BY
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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.