Variability in Hypertension Management and Data Capture Capacity in Primary Health Care Centers in the Federal Capital Territory of Nigeria

Abstract

Background: Elevated blood pressure (BP) is a leading risk factor for cardiovascular disease (CVD) morbidity and mortality in Nigeria. The Transforming Hypertension Management in Nigeria (HTN) Program aims to adapt, implement, and evaluate the effectiveness and implementation outcomes of a 5-year system-level hypertension control program in 60 primary healthcare centers (PHCs) in Nigeria. Due to the large scale of the HTN Program, PHCs may have different access to equipment, diagnostic and treatment capacity, as well as data capture capacities. Therefore, this project aimed to 1) evaluate and compare service availability and readiness across PHCs; and 2) monitor and report on baseline data entry errors from each PHC in the hypertension registry.Method: Site readiness and capacity was evaluated using the Service Availability and Readiness Assessment (SARA) methodology of the World Health Organization. Patient level data were extracted from the HTN Program patient registry, which is a longitudinal REDCap database. Graphical representations are used to assess the facility-based capacity and readiness for hypertension diagnosis and treatment. Tables were created to list records with various data entry errors at baseline for each site. Results: Across six council areas within the FCT, there was variability in the presence of basic amenities, equipment, infection prevention, diagnostic capacity and essential medicines. Cardiovascular service availability was consistently high, whereas wide variability was also demonstrated in indicator scores for the presence of guidelines, equipment, and medicines. Missing data and mismatched record Ids are the most common data entry errors across all sites. Variability in the frequency and type of data entry errors exists across sites.Discussion: While service availability and readiness was overall sufficient in the FCT, variability in the hypertension treatment cascade and data capture capabilities exists across primary healthcare centers. Consistent staff trainings and feedback on service implementation and electronic data capture is critical to effective hypertension monitoring, control and treatment.

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