Facilitators and barriers in prevention of cardiovascular disease in Limpopo, South Africa: a qualitative study conducted with primary health care managers

Mbuyiselo Douglas,Tebogo Mothiba,Linda Skaal,Mpsanyana Makgahlela,Geofrey Musinguzi,Tholene Sodi,Hilde Bastiaens,Nancy Kgatla

doi:10.1186/s12872-021-02290-1

Mbuyiselo Douglas, Tebogo Mothiba + Show 6 more

Open Access

https://doi.org/10.1186/s12872-021-02290-1

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Abstract

BackgroundIn the Southern African countries, cardiovascular disease burden is increasing and the second most prevalent cause of death after infectious diseases. The sustainable primary prevention of cardiovascular disease is associated with the engagement of facilitators that support it and hindered by barriers that undermine the support of a healthy lifestyle at the community level. The purpose of the study was to investigate facilitators and barriers at the level of primary health care facilities, on prevention of cardiovascular disease in Limpopo Province of South Africa.MethodsThis study is an exploratory and descriptive qualitative design, where open-ended key informant interviews were conducted among 20 primary health care managers conveniently sampled in their respective health care facilities. Coding and analysis were done using the thematic analysis method with the assistance of Atlas ti qualitative software.ResultsVarious facilitators for the prevention of CVD were identified in this study. One of such facilitators is the availability and adherence to CVD treatment guidelines in the district. Other facilitators included top-down health education programme; collaboration with schools, traditional and religious leaders; the use of modern technology; and a structured healthcare system. Barriers were also identified as poor infrastructural development; shortage of medical supplies and equipment; lack of health promotion activities; shortage of nurses and other health care personnel; and poor accessibility to primary health care services.ConclusionThis study has identified barriers and facilitators that may be harnessed to improve cardiovascular disease prevention, care, and management in a rural setting in South Africa. The facilitators should be strengthened, and barriers identified redressed.Trial registration number: REC-0310111-031.

Highlights

In the Southern African countries, cardiovascular disease burden is increasing and the second most prevalent cause of death after infectious diseases
A study conducted by Nojila et al [2] stated that Black South Africans are experiencing relatively high agestandardised death rates (ASDRs) from cerebrovascular disease, hypertensive heart disease, diabetes mellitus, ischaemic heart disease (IHD) and cardiomyopathy compared to Coloureds, Asians, and Whites
The facilitators and barriers that affect the prevention and management of cardiovascular disease (CVD) were identified at the Polokwane Municipality in Limpopo Province

Summary

Introduction

In the Southern African countries, cardiovascular disease burden is increasing and the second most prevalent cause of death after infectious diseases. The purpose of the study was to investigate facilitators and barriers at the level of primary health care facilities, on prevention of cardiovascular disease in Limpopo Province of South Africa. The dynamics are changing, and the World Health Organization (WHO) has projected that by the year 2030, CVD will surpass communicable diseases as the leading cause of death in the African continent [4]. People in low and middle-income settings often do not have the benefit of integrated primary health care (PHC) programmes for prevention, early detection and treatment of CVD compared to those in high-income settings [4]. In 2013, an estimated one million premature deaths were attributed to CVD in Sub-Saharan Africa, constituting 5.5% of all global CVD-related deaths and 11.3% of all deaths from different causes [5]

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