Primary Care Capacity

Provider training improved knowledge and strengthened record-keeping and community trust. Intervention participants continued to prefer higher-level facilities for hypertension follow-up, likely because primary care lacked physician-led titration and complication assessment. Resource needs included funding, staff, training time, administrative capacity, management support and IT systems. Primary care capacity was the dominant barrier to implementing NAT-C. The article concludes that lack of system capacity, rather than lack of perceived value, was the main barrier to wider implementation. Public primary healthcare facilities offered free hypertension services, but physician availability was absent in study-cluster public facilities. Medication stockouts and missing diagnostic and recording tools limited service delivery. Clinicians became less confident after delivering NAT-C that adequate resources and management support would be available. Some clinicians worried that finding unmet needs without capacity to address them would create ethical and practical problems. Sustained hypertension control in low-resource urban settings requires community support integrated with reliable pr…