Assessment of the Effectiveness of Community Health Promoters in Hypertension Care in Imenti North Sub-County, Kenya
Vincent Mukundi Gitonga *
School of Health Sciences, Meru University of Science and Technology, Meru, Kenya.
Ananias Njagi Nkonge
School of Health Sciences, Meru University of Science and Technology, Meru, Kenya.
Elias Kinoti
School of Health Sciences, Meru University of Science and Technology, Meru, Kenya.
Patrick Kubai
School of Health Sciences, Meru University of Science and Technology, Meru, Kenya.
*Author to whom correspondence should be addressed.
Abstract
Background: Hypertension remains an important public health challenge in Imenti North Sub-County, Meru County, Kenya, where Community Health Promoters (CHPs) support community-based screening, monitoring, education, and treatment adherence.
Aim: This study assessed the effectiveness of CHPs in hypertension care by examining blood-pressure monitoring resources, adherence support, and barriers to service delivery.
Methods: A descriptive cross-sectional survey was conducted among 208 CHPs selected by simple random sampling from 450 CHPs across 45 community units. Data were collected using a structured questionnaire and analyzed in SPSS using descriptive and inferential statistics.
Results: Almost all CHPs had received initial hypertension-care training (99.0%), and 91.8% had access to functional blood-pressure machines. Weekly machine use was reported by 66.4%. Medication adherence counselling was provided by 96.6% of CHPs, while 89.4% used home visits as the primary follow-up method. Patient-reported improvement in medication adherence was reported by 97.1% of CHPs. However, only 48.1% had received refresher training, 54.8% identified lack of refresher training as the leading training challenge, and 66.8% experienced battery stock-outs lasting more than one day. Batteries were cited as the dominant resource barrier by 94.7%. Refresher training and resource availability were significantly associated with reported care outcomes.
Conclusion: The findings indicate an important role for CHPs in community-based hypertension care in Imenti North Sub-County. Regular refresher training, reliable supplies, and attention to workload and mobility barriers may strengthen the consistency and quality of care.
Keywords: Community Health Promoters, hypertension, adherence, blood pressure monitoring, barriers, Kenya, primary health care