"Patient perceptions and preferences during a community-based telehealth care model for moderate-to-severe hypertension in rural communities in Kenya and Uganda"

Johnson-Peretz J, Mutabazi A, Byamukama A, et al. (2026). PLOS One.

“<Community care> is a good idea, and it makes it cheap for us to access high blood pressure care and treatment. At the same time, this community-based care for high blood pressure would increase awareness creation. When providers come to my place and they find me with other people, those people will ask me who you are. Of course, I will tell them, and from there, some may ask me again what the signs of high blood pressure are. They will also develop that interest to know their status concerning High blood pressure.” (57 y.o. Male, intervention arm, Kenya)

“At the clinic, one interacts with fellow patients, which provides courage on the grounds that I am not the only sick person in the world. People may be suffering from different ailments, but all in all, I am not the only sick person, including those who may be sharing the same condition as mine.” (70 y.o. male, intervention arm, Kenya)​

Synopsis: An analysis of participant perceptions around clinician-driven, community-health worker facilitated hypertension care using telehealth technologies, compared to perceptions of control participants. Data drawn from in-depth, semi-structured interviews with purposively selected healthcare providers (clinicians and CHWs; N = 15) and participants (N = 40). Access to hypertension care can be challenging, especially in rural areas of Sub-saharan Africa. Overcoming barriers to hypertension care remains a priority. Pairing community health worker (CHW) and telehealth modalities offers one way to extend the reach of hypertension care without overburdening patients or healthcare systems in rural areas.

Key Findings: Overall, participants who were exposed to CHW-facilitated telehealth (those randomised to the intervention arm) felt a high degree of satisfaction with the intervention. In contrast, those in the control arm of the study who received hypertension care at the clinic had some reservations about the idea of community-based care, including potential concerns about the quality of care and misconceptions that CHW telehealth would preclude them from receiving clinic-based care. Participants in both arms, however, expressed consensus that community-based care saved or would save on transport costs and reach those who live at a distance from public transport routes. Additionally, participants thought that receiving medication at home could also help those who were old or unwell because of physical injury or an acute illness and could not easily attend facilities. 
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Recommendations: Strategies to foster trust in CHWs and telehealth are important for effective implementation of CHW-facilitated telehealth programs. Further, clinic-based providers should regularly check in with patients to solicit feedback on their experience with telehealth and ensure that patient-provider communication remains intact during check-in visits when patients are not physically attending clinic. Finally, because of the social nature of telehealth as a healthcare system option, incorporating the use of social media and social networks may be one way to raise awareness of this option for hypertension care.