Healthcare Providers’ Perspectives on the Usefulness and Utilisation of Hypertension Management Guidelines in Primary Health Facilities: A Qualitative Study in Dodoma Municipality

Abstract

Background: Hypertension is a major modifiable risk factor for cardiovascular disease and premature mortality, with
a growing burden in low- and middle-income countries, including Tanzania, where awareness, treatment, and control
remain suboptimal. Clinical guidelines for hypertension management are essential tools that support healthcare providers
in delivering evidence-based care, particularly for those with limited training. In primary health care (PHC) settings,
effective implementation of these guidelines is pivotal for ensuring quality and standardised care. Despite the availability
of hypertension guidelines in Tanzania and the critical role of PHC providers in their application, hypertension prevalence
continues to rise in both rural and urban populations. Furthermore, evidence on healthcare providers’ perceptions of these
guidelines’ usefulness and application in PHC settings remains limited, despite its importance for improving adherence
and patient outcomes. This study aimed to explore healthcare providers’ perspectives on the usefulness and utilisation of
hypertension management guidelines in PHC facilities in Dodoma.
Methods: A descriptive qualitative study design was conducted in selected PHC facilities in Dodoma Municipality. A
total of 18 healthcare providers participated in four focus group discussions (FGDs) conducted in May and June 2024.
Participants were purposively selected based on their involvement in hypertension management. Data were collected
using an interview guide and analysed using a thematic analysis framework.
Results: Two main themes emerged. The first theme, the significance of hypertension management guidelines, included
four subthemes: supporting clinical decision-making; serving as reminders and clarifying care processes; enhancing
patient monitoring and follow-up; and facilitating patient counselling. The second theme, strategies to enhance guideline
utilisation, comprised regular guideline updates, on-the-job training, and improved accessibility within health facilities.
No substantial disconfirming views were reported; however, variability in emphasis on accessibility and training needs
was observed across participants.
Conclusion: Healthcare providers perceive hypertension management guidelines as essential tools for clinical decision
making, counselling, and follow-up. These findings reflect providers’ perspectives and suggest that strengthening guideline
updates, training, and accessibility may enhance utilisation. Future studies should include higher-level facilities to provide
a more comprehensive understanding of guideline implementation