Implementing Evidence-Based Task Strengthening Strategies for Hypertension Control within Ghana’s Community-Based Health Planning Services: A Concept Mapping Analysis

Background: As efforts are made to systematically implement an evidence-based task-strengthening strategy for hypertension control (TASSH) in Ghana, understanding their content can help national, regional and district health stakeholders within Ghana’s Health Services (GHS) identify strategies for enhancing intervention uptake and sustainability in their local context. This study sought to describe national, regional and district health stakeholders’ perspectives and characterize the array of strategies needed to enhance the uptake of evidence-based TASSH within Ghana’s Community-based Health and Planning Services (CHPS) zones. Methods: This qualitative study was conducted among national, regional and district health stakeholders within GHS serving patients who utilize CHPS zones. The CHPS initiative is Ghana’s flagship strategy for achieving universal health coverage. Semi-structured interviews were conducted with 22 national, regional and district health stakeholders identified via purposive sampling. Interviews were conducted in 2018. Data analysis was conducted between July 2019 and December 2019. Data was analyzed using group concept mapping systems to identify major themes and subthemes.Results: About 68 % of participants were male with mean age of 40 years and mean years of experience providing hypertension-related care within GHS of 9 years. A conceptual map emerged, consisting of 46 strategies needed for implementing evidence-based TASSH, organized into 6 clusters: 1) Referral Systems; 2) Availability of Equipment; 3) Protocols and Guidelines; 4) Capacity Building/Training; 5) Policy Reform, and 6) Technical Support and Supervision. Availability of equipment was rated as the most important strategy (mean 4.80 out of 5) needed to implement evidence-based TASSH, while Capacity Building/Training was rated as the most feasible strategy (mean 4.20 out of 5) to address. Although important (mean 4.40 out of 5), Policy reform was rated as the least important and feasible strategy to address. Conclusions: These findings demonstrate strategies that can help inform future interventions focused on the adoption and sustainability of evidence-based TASSH within Ghana’s CHPS zones. Also, national, regional and district health stakeholders can support healthcare workers by facilitating access to equipment and strategies for enhancing capacity and training with implementing evidence-based task-shifting hypertension interventions in Ghana.