Author
Listed:
- Mariet Benade
- Zandile Mchiza
- Rafeya V Raquib
- Sridevi K Prasad
- Lily D Yan
- Alana T Brennan
- Justine Davies
- Nikkil Sudharsanan
- Jennifer Manne-Goehler
- Matthew P Fox
- Jacob Bor
- Sydney B Rosen
- Andrew C Stokes
Abstract
Hypertension is a major contributor to global morbidity and mortality. In South Africa, the government has employed a whole systems approach to address the growing burden of non-communicable diseases. We used a novel incident care cascade approach to measure changes in the South African health system’s ability to manage hypertension between 2011 and 2017. We used data from Waves 1–5 of the National Income Dynamics Study (NIDS) to estimate trends in the hypertension care cascade and unmet treatment need across four successive cohorts with incident hypertension. We used a negative binomial regression to identify factors that may predict higher rates of hypertension control, controlling for socio-demographic and healthcare factors. In 2011, 19.6% (95%CI 14.2, 26.2) of individuals with incident hypertension were diagnosed, 15.4% (95%CI 10.8, 21.4) were on treatment and 7.1% had controlled blood pressure. By 2017, the proportion of individuals with diagnosed incident hypertension had increased to 24.4% (95%CI 15.9, 35.4). Increases in treatment (23.3%, 95%CI 15.0, 34.3) and control (22.1%, 95%CI 14.1, 33.0) were also observed, translating to a decrease in unmet need for hypertension care from 92.9% in 2011 to 77.9% in 2017. Multivariable regression showed that participants with incident hypertension in 2017 were 3.01 (95%CI 1.77, 5.13) times more likely to have a controlled blood pressure compared to those in 2011. Our data show that while substantial improvements in the hypertension care cascade occurred between 2011 and 2017, a large burden of unmet need remains. The greatest losses in the incident hypertension care cascades came before diagnosis. Nevertheless, whole system programming will be needed to sufficiently address significant morbidity and mortality related to having an elevated blood pressure.
Suggested Citation
Mariet Benade & Zandile Mchiza & Rafeya V Raquib & Sridevi K Prasad & Lily D Yan & Alana T Brennan & Justine Davies & Nikkil Sudharsanan & Jennifer Manne-Goehler & Matthew P Fox & Jacob Bor & Sydney B, 2023.
"Health systems performance for hypertension control using a cascade of care approach in South Africa, 2011–2017,"
PLOS Global Public Health, Public Library of Science, vol. 3(9), pages 1-16, September.
Handle:
RePEc:plo:pgph00:0002055
DOI: 10.1371/journal.pgph.0002055
Download full text from publisher
Corrections
All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pgph00:0002055. See general information about how to correct material in RePEc.
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
We have no bibliographic references for this item. You can help adding them by using this form .
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: globalpubhealth (email available below). General contact details of provider: https://journals.plos.org/globalpublichealth .
Please note that corrections may take a couple of weeks to filter through
the various RePEc services.