Availability, functionality and access of blood pressure machines at the points of care in public primary care facilities in Tororo district, Uganda

Abstract

Background: Early diagnosis of hypertension prevents a significant number of complications and premature deaths. In resource-variable settings,  diagnosis may be limited by inadequate access to blood pressure (BP) machines. We sought to understand the availability, functionality and access  of BP machines at the points of care within primary care facilities in Tororo district, Uganda.
Methods: This was an explanatory sequential mixed-methods study combining a structured facility checklist and key informant interviews with  primary care providers. The checklist was used to collect data on availability and functionality of BP machines within their organisational  arrangements. Key informant interviews explored health providers’ access to BP machines.
Results: The majority of health facilities reported at least one working BP machine. However, Health providers described limited access to machines  because they are not located at each point of care. Health providers reported borrowing amongst themselves within their respective units or from  other units within the facility. Some health providers purchase and bring their own BP machines to the health facilities or attempted to restore the  functionality of broken ones. They are motivated to search the clinic for BP machines for some patients but not others based on their perception of  the patient’s risk for hypertension.
Conclusion: Access to BP machines at the point of care was limited. This makes hypertension screening selective based on health providers’  perception of the patients’ risk for hypertension. Training in proper BP machine use and regular maintenance will minimise frequent breakdowns.