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Table 3 Ways to address short- and long-term needs related to hypertension within Guatemala’s public primary care system

From: Hypertension in Guatemala’s Public Primary Care System: A Needs Assessment Using the Health System Building Blocks Framework

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