title: Literacy and motivation for the prevention and control of hypertension among female community health volunteers: a qualitative study from Nepal.
abstract: BACKGROUND
  The prevalence of hypertension is increasing in Nepal. Thus, there is a need for a programme to improve primary healthcare. One possibility is to assign prevention, diagnosis, and treatment of hypertension to female community health volunteers (FCHVs).
  
  
  OBJECTIVE
  To assess literacy and motivation to be involved in a hypertension prevention and control programme in Nepal among FCHVs.
  
  
  METHODS
  Five focus group discussions (FGDs) were conducted with a total of 69 FCHVs in Lekhnath municipality, Kaski district, Nepal. Seven themes were developed on the basis of data collection: 1) knowledge about hypertension; 2) risk factors of hypertension; 3) prevention and control of hypertension; 4) access to treatment for hypertension in the community; 5) learning about blood pressure measurement; 6) ability to raise blood pressure awareness in the community; 7) possible challenges for their future involvement. Data were analysed using the thematic analysis approach.
  
  
  RESULTS
  FCHVs have some knowledge about diagnosis, risk factors, and complications of hypertension. General unanimity was observed in the understanding that hypertension and risk factors needed to be addressed. The willingness of FCHVs to contribute to prevention, control, and management was strong, and they were confident that with some basic training they could obtain skills in hypertension management.
  
  
  CONCLUSIONS
  Despite limited knowledge about hypertension, FCHVs expressed willingness and readiness to be trained in hypertension management. This study supports the possibility of involving FCHVs in prevention and control of hypertension in Nepal.
authors.affiliation: Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark; dn@ph.au.dk.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Neupane
authors.affiliation: Rural Clinical School, University of New South Wales, Sydney, Australia.
authors.forename: Craig S
authors.initials: CS
authors.lastname: Mclachlan
authors.affiliation: Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark.
authors.forename: Rupesh
authors.initials: R
authors.lastname: Gautam
authors.affiliation: Nepal Development Society, Chitwan, Nepal.
authors.forename: Shiva Raj
authors.initials: SR
authors.lastname: Mishra
authors.affiliation: Faculty of Social Sciences, Aalborg University, Aalborg, Denmark.
authors.forename: Michael
authors.initials: M
authors.lastname: Thorlund
authors.affiliation: Department of Culture and Society, Aarhus University, Aarhus, Denmark.
authors.forename: Mette
authors.initials: M
authors.lastname: Schlütter
authors.affiliation: Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark.
authors.forename: Per
authors.initials: P
authors.lastname: Kallestrup
mesh_terms: D000328:Adult; D000368:Aged; D003150:Community Health Workers / Q000193:education / Q000523:psychology; D005260:Female; D017144:Focus Groups; D057220:Health Literacy / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000628:therapy; D008875:Middle Aged; D009042:Motivation; D009390:Nepal; D036301:Qualitative Research; D014838:Volunteers; D055815:Young Adult
keywords: Nepal; community health workers; female community health volunteer; focus group discussion; health literacy; hypertension; prevention; primary care