Ofili M Isioma

Nurses are involved in the prevention and management of chronic diseases like hypertension in primary health care settings. However, information about the roles of nurses in prevention and managing high blood pressure in South-South Nigeria remains scarce. Therefore, this research attempts to relate the performance of nurses roles in preventing high blood pressure with their qualifications in primary health care centres in Delta State. Interviewer’s administered questionnaire was used to gather information from eighty-five nurses chosen from the twenty-nine randomly selected primary health care centres in the twenty five local government areas of Delta State. Results show that the nurses performed the roles at varying degrees judged to be poor overall. The nurses’ identified roles and level of performance bear no significant relationship to their qualifications. It was also observed that most of the nurses had no training in the management of hypertension and do not use the recommended NHA guidelines. These indicate the need for facilitators to organize training courses on hypertension management for nurses, and integrate such into the curriculum for nursing education.

Hypertension (high blood pressure) is presently one of the most important risk factors for the development of cardiovascular diseases. Several developed and developing nations including Nigeria have adopted various initiatives to prevent and/or manage hypertension. This article entails the development of guidelinesby means of integrated and collaborative approach involving experts knowledgeable in the field coupled with community actionin rural settings in Delta State Nigeria. Using the Nominal Group Technique meeting, a group of seven key stakeholders knowledgeable in the field were brought together to harmonize their ideas and experiences within a period of three days. The meeting lasted six hours each day.Each round addressing a topic lasted for an hour and 45 minutes.Major concepts addressed were: optimal diagnosis and appropriate medical evaluation for high blood pressure, principles of blood pressure measurement and different steps in blood pressure measurement. Others are management options (routine baseline investigations, pharmacological and non-pharmacological measures) and prevention of high blood pressure as well as community screening programmes. This simple guideline will not only serve as a vade mecum but will also have a strong impact on the health, quality of life and mortality rate among rural communities in Nigeria.

Hypertension is a global health challenge affecting many adults. Cultural perception has been identified to affect disease progression and management. This article describes the experiences of a typical rural community in Delta State Nigeria in terms of their various traditional and cultural practices and the influence these have on the management and prevention of high blood pressure in the community. An ethnographic study was conducted utilizing in-depth interviews method. Ten known hypertensive patients were purposively selected who had blood pressure readings of ≥140/90 mmHg observed on three separate occasions from a previous survey conducted in the same community, and who had also confirmed their use of traditional practices in the management of high blood pressure. The traditional and cultural practices identified were: medicinal plants, sacrifices, scarification and tribal marks. Anti-hypertensive drugs were used alongside with traditional practices and where these traditional practices fail, local diets served as a remedy. These cultural practices such as local foodstuffs and dietary preferences (especially the palm kernel soup, which is a high cholesterol item), may either predispose them to risk factors of certain diseases or promote their health (as do the medicinal plants and some herbal preparations). Models of community based management of hypertension in rural settings is highly recommended. This will help retain and preserve relevant cultural values and serve to maintain community wellbeing.