Bridging the gaps in the unmet needs of hypertension care in Nigeria: post-intervention evaluation of the community action against non-communicable diseases (COMAAND) project

Abstract

BACKGROUND: Non-communicable diseases (NCDs), of which hypertension is one of the major drivers, have become a global public health burden, leading to at least 70% of deaths globally. Community action against non-Communicable diseases (COMAAND) is an innovative community-based intervention focused on improving the early detection and timely management of hypertension in Nigeria. In this report, we aim to evaluate the effectiveness of the intervention in improving key hypertension management outcomes including hypertension awareness, treatment, and blood pressure control after two years of implementing the intervention (between November 2019 to January 2022). METHODS: We evaluated the COMAAND intervention using a mixed method design (combining cross-sectional survey and longitudinal study). We conducted a community-wide cross-sectional survey to assess community level awareness, treatment, and blood pressure control at the end of the two years of intervention implementation. We used the one sample chi-squared test to compare categorical variables, and the one sample t-test for continuous variable between the pre-intervention and the post-intervention study. We also collected longitudinal data of patients enrolled at participating health care facilities and evaluated treatment adherence. RESULTS: ) and systolic BP (130.1 mmHg vs. 135.0 mmHg) reduced significantly (p < 0.05) at post-intervention compared to pre-intervention. Cigarette smoking and alcohol intake were reduced at the post-intervention compared to pre-intervention (5.3% vs. 26.6% and 40.3% vs. 62.1%), respectively. Hypertension awareness increased by 36.8%, and treatment increased by 111.1% at the post-intervention compared to pre-intervention. CONCLUSION: The COMAAND project helped in improving hypertension care in a community setting. CLINICAL TRIAL NUMBER: Not applicable.