Table 3 Ways to address short- and long-term needs related to hypertension within Guatemala’s public primary care system
Health system building block | Short-term needs (that may be addressed by the project) | Long-term needs (requiring an investment beyond the scope of the project) |
|---|---|---|
Service delivery | • Disseminate treatment guidelines for the detection and management of hypertension to all Ministry of Health providers at the primary care level • Develop a standardized approach to the collection and assessment of blood pressure indicators | • Improve coverage and physical infrastructure and access to medical supplies • Integrate prevention and health promotion into the approach to address hypertension |
Human resources | • Offer in-service health care training on hypertension management to providers at all levels • Train providers on involving patients in blood pressure management | • Reduce staff turnover and increase professional/career advancement opportunities • Update the curriculum for auxiliary nurses to cover training in hypertension management |
Information systems | • Standardize clinical forms and documentation of hypertension • Implement communication between patients and providers to share health data to improve management | • Develop hypertension & NCD health and service delivery measures that are feasible to track |
Medications and Technologies | • Improve administrative capacity to request needed quantity of medications • Capture traditional health remedies that patients use to manage their blood pressure | • Ensure that all medications in the treatment guidelines are consistently available in health centers and posts • Increase laboratory capacity for diagnosis, treatment and management of NCDs • Increase the affordability of medications |
Financing | • Increase the investment in preventive health vs. curative care • Estimate the cost of care for patients with hypertension | • Increase the Ministry of Health’s budget • Shift funding to match the epidemiologic profile of the country • Reduce high-out-of-pocket costs for patients |
Leadership and Governance | • Increase community members’ participation in hypertension management • Empower patients with hypertension to seek treatment | • Establish intersectoral collaborations to address chronic conditions • Invest resources in regulation and health promotion • Develop a national strategic plan to cultivate high-level support for NCDs |