title: Exploring stakeholders' perceptions of a task-shifting strategy for hypertension control in Ghana: a qualitative study.
abstract: The purpose of this study was to explore stakeholders' perception of an on-going evidence-based task-shifting strategy for hypertension (TASSH) in 32 community health centers and district hospitals in Ghana.
  
  
  
  Using focus group discussions and in-depth interviews, qualitative data were obtained from 81 key stakeholders including patients, nurses, and site directors of participating community health centers involved in the TASSH trial. Qualitative data were analyzed using open and axial coding techniques.
  
  
  
  Analysis of the qualitative data revealed three themes that illustrate stakeholders' perceptions of the ongoing task-shifting strategy for blood pressure control in Ghana and they include: 1) awareness and understanding of the TASSH program; 2) reasons for participation and non-participation in TASSH; and 3) the benefit and drawbacks to the TASSH program.
  
  
  
  The findings support evidence that successful implementation of any task-shifting strategy must focus not only on individual patient characteristics, but also consider the role contextual factors such as organizational and leadership factors play. The findings also demonstrate the importance of understanding stakeholder's perceptions of evidence-based task-shifting interventions for hypertension control as it may ultimately influence the sustainable uptake of these interventions into "real world" settings.
authors.affiliation: Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, College of Applied Health Sciences, Champaign, USA. jiwez@illinois.edu.
authors.forename: Juliet
authors.initials: J
authors.lastname: Iwelunmor
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, USA.
authors.forename: Joyce
authors.initials: J
authors.lastname: Gyamfi
authors.affiliation: Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors.forename: Jacob
authors.initials: J
authors.lastname: Plange-Rhule
authors.affiliation: Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, College of Applied Health Sciences, Champaign, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Blackstone
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, USA.
authors.forename: Nana Kofi
authors.initials: NK
authors.lastname: Quakyi
authors.affiliation: Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors.forename: Michael
authors.initials: M
authors.lastname: Ntim
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, USA.
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Zizi
authors.affiliation: Ghana Health Services, Accra, Ghana.
authors.forename: Kwasi
authors.initials: K
authors.lastname: Yeboah-Awudzi
authors.affiliation: Ghana Health Services, Accra, Ghana.
authors.forename: Alexis
authors.initials: A
authors.lastname: Nang-Belfubah
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, USA.
authors.forename: Gbenga
authors.initials: G
authors.lastname: Ogedegbe
mesh_terms: D001291:Attitude of Health Personnel; D001794:Blood Pressure; D003151:Community Health Centers; D003659:Decision Making, Organizational; D005260:Female; D017144:Focus Groups; D005869:Ghana; D006296:Health Services; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000628:therapy*; D036301:Qualitative Research