Building capacity in non-physician healthcare workers to implement hypertension management in the primary healthcare settings in nigeria: a multi-state pre-post evaluation of the htn 2.0 training program
Authors & Affiliations
Chidubem Okoli 1, Greatness O. Eyenor 1, Kukyem D. Azi 1, Michael U. Ochem 1, Mercy U. Ikechukwu-Orji 1, Anthony Orji 1, Efosa G. Uhunwangho 1, Margareth E. Aba 1, Esther A. Agoji 1, Charity Akor 1, Ahmad A. Mohammad 1, Pamela Ogefere 1, Abdullahi Farouk 1, Oluwatosin Makinde 1, Chinedu Iro 1, Innocent I. Chukwuonye 2, Ejiroghene Martha Umuerri 3, Yekeen A. Ayoola 4, Mahmoud U. Sani 5, Okechukwu S. Ogah 6, Dike B. Ojji 1, Mark D. Huffman 7 Hypertension Investigator’s affiliation 1. Cardiovascular Research Center, University of Abuja Teaching Hospital, Abuja, 2. Department of Internal Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria 3. Department of Medicine, Delta State University Teaching Hospital, Oghara, Nigeria 4. Department of Internal Medicine, Federal Teaching Hospital, Gombe, Gombe, Nigeria 5. Department of Medicine, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria. 6. Department of Internal Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria 7. Cardiovascular Division and Global Heath Center, Washington University in St. Louis, St. Louis Missouri, USA
📖 Abstract Content
Hypertension is a leading cause of cardiovascular morbidity and mortality globally, with a disproportionately high burden in low- and middle-income countries such as Nigeria. Weak primary healthcare (PHC) systems and limited frontline healthcare worker capacity contribute to poor hypertension control. The Hypertension Treatment in Nigeria (HTN) 2.0 Program is designed to strengthen PHC systems through standardized care and capacity building. We evaluated the effectiveness of a training program in improving healthcare worker knowledge of hypertension management.
A multi-state training program was conducted across five Nigerian states (Abia, Delta, Gombe, Jigawa, and Oyo) as part of the HTN 2.0 formative work. A structured 3-day workshop was delivered to PHC workers. Training modules, adapted from the WHO, CDC, and the Nigerian Simplified Hypertension Treatment Protocol, covered hypertension management, aligning with the HEARTS technical package. Knowledge acquisition was assessed using pre- and post-training tests. Descriptive and inferential statistics were used to evaluate effectiveness.
A total of 229 healthcare workers from 50 PHCs participated. Post-test scores were significantly higher than pre-test scores across all states (p < 0.05). Gombe recorded the largest improvement (mean increase: 30.95%; r = 0.88), while Oyo had the smallest (mean increase: 7.71%; r = 0.41). By cadre, records officers and pharmacy technicians had the largest gains (r = 0.85 and r = 0.74, respectively), while CHEWs and officers-in-charge showed moderate gains.
HTN 2.0 training Program significantly improved the knowledge of PHC workers, demonstrating the effectiveness of a structured program that utilized validated training modules.
