Level of understanding and community-level barriers to the management of hypertension: a qualitative study in eight coastal communities in Ghana

Hypertension has a significant impact on healthcare systems in Sub-Saharan Africa. Despite Ghana’s high prevalence of hypertension, health system barriers impede its detection, treatment and control. This study assessed the level of understanding and systemic barriers that influence hypertension detection, management and control. This qualitative study was conducted in coastal communities in the Greater Accra Region of Ghana between December 2023 and January 2024. Participants with hypertension, healthcare professionals and religious/ traditional leaders were purposively selected to ensure a diverse representation of perspectives. A total of 14 focus group discussions (FGDs) and 56 in-depth interviews (IDIs) were conducted. All FGDs and IDIs were audio recorded, transcribed and analysed using the qualitative software package, Atlas.ti. The themes identified included lay description of hypertension, perceived causes/risks of hypertension, caregiving, knowledge on management and prevention, knowledge on complications of hypertension, impact of hypertension, challenges of living with hypertension and actions by faith-based organisations regarding hypertension and its management. Although patients hold positive views of support systems for hypertension management, financial restrictions, distance to healthcare and stigma hindered hypertension management. Residents in these coastal communities tend to understand hypertension, its management and its problems. The identified barriers for management of hypertension in these communities include financial and structural constraints. Despite these obstacles, these people understood the need for social support, as families, individuals and religious organisations help hypertensive patients financially and socially.