title: A Narrative Synthesis of the Health Systems Factors Influencing Optimal Hypertension Control in Sub-Saharan Africa.
abstract: BACKGROUND
  In sub-Saharan Africa (SSA), an estimated 74.7 million individuals are hypertensive. Reducing the growing burden of hypertension in sub-Saharan Africa will require a variety of strategies one of which is identifying the extent to which actions originating at the health systems level improves optimal management and control.
  
  
  RESULTS
  We conducted a narrative synthesis of available papers examining health systems factors influencing optimal hypertension in SSA. Eligible studies included those that analyzed the impact of health systems on hypertension awareness, treatment, control and medication adherence. Twenty-five articles met the inclusion criteria and the narrative synthesis identified the following themes: 1) how physical resources influence mechanisms supportive of optimal hypertension control; 2) the role of human resources with enabling and/or inhibiting hypertension control goals; 3) the availability and/or use of intellectual resources; 4) how health systems financing facilitate and/or compromise access to products necessary for optimal hypertension control.
  
  
  CONCLUSIONS
  The findings highlight the need for further research on the health systems factors that influence management and control of hypertension in the region.
authors.affiliation: Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, United States of America.
authors.forename: Juliet
authors.initials: J
authors.lastname: Iwelunmor
authors.affiliation: School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors.forename: Jacob
authors.initials: J
authors.lastname: Plange-Rhule
authors.affiliation: Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States of America.
authors.forename: Collins O
authors.initials: CO
authors.lastname: Airhihenbuwa
authors.affiliation: Department of Neurology, Georgia Regents University, Augusta, GA, United States of America.
authors.forename: Chizoba
authors.initials: C
authors.lastname: Ezepue
authors.affiliation: Center for Healthful Behavior Change, Division of General Internal Medicine, Department of Medicine, New York University Langone Medical Center, New York, New York, United States of America.
authors.forename: Olugbenga
authors.initials: O
authors.lastname: Ogedegbe
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data*; D006280:Health Workforce / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D048088:Informatics / Q000379:methods*