Abstract
BackgroundElevated blood pressure is the leading risk for mortality in the world. Task redistribution has been shown to be efficacious for hypertension management in low- and middle-income countries. However, the workforce requirements for such a task redistribution strategy are largely unknown. Therefore, we developed a needs-based workforce estimation model for hypertension management in western Kenya, using need and capacity as inputs.MethodsKey informant interviews, focus group discussions, a Delphi exercise, and time-motion studies were conducted among administrative leadership, clinicians, patients, community leaders, and experts in hypertension management. These results were triangulated to generate the best estimates for the inputs into the health workforce model. The local hypertension clinical protocol was used to derive a schedule of encounters with different levels of clinician and health facility staff. A Microsoft Excel-based spreadsheet was developed to enter the inputs and generate the full-time equivalent workforce requirement estimates over 3 years.ResultsTwo different scenarios were modeled: (1) “ramp-up” (increasing growth of patients each year) and (2) “steady state” (constant rate of patient enrollment each month). The ramp-up scenario estimated cumulative enrollment of 7000 patients by year 3, and an average clinical encounter time of 8.9 min, yielding nurse full-time equivalent requirements of 4.8, 13.5, and 30.2 in years 1, 2, and 3, respectively. In contrast, the steady-state scenario assumed a constant monthly enrollment of 100 patients and yielded nurse full-time equivalent requirements of 5.8, 10.5, and 14.3 over the same time period.ConclusionsA needs-based workforce estimation model yielded health worker full-time equivalent estimates required for hypertension management in western Kenya. The model is able to provide workforce projections that are useful for program planning, human resource allocation, and policy formulation. This approach can serve as a benchmark for chronic disease management programs in low-resource settings worldwide.
Highlights
Elevated blood pressure is the leading risk for mortality in the world
The global burden of hypertension predominates in lowand middle-income countries (LMICs), with 80% of hypertension-related deaths occurring in those regions [1]
We describe the development of a needsbased workforce estimation model for hypertension management in Kenya, modeled after a similar workforce estimation model developed for human immunodeficiency virus (HIV) care in Mozambique [13]
Summary
Task redistribution has been shown to be efficacious for hypertension management in low- and middle-income countries. The global burden of hypertension predominates in lowand middle-income countries (LMICs), with 80% of hypertension-related deaths occurring in those regions [1]. Treatment and control rates in these regions are poor [2, 3], due to inequitable access to health care, failure to uptitrate anti-hypertensive therapy, co-morbidities Given the severe shortage of physicians in LMICs, task redistribution of hypertension care from physicians to non-physician health workers could improve hypertension treatment and control rates in low-resource settings worldwide [11, 12]. We aimed to estimate the number of physicians, nurses, clinical officers, and auxiliary personnel necessary to provide stable, long-term care for patients with hypertension in this resource-limited setting
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
