Evaluation of a Sentinel Hypertension Surveillance System in Mojo, East Shewa Zone, Oromia, Ethiopia: Insights from a Concurrently Embedded Mixed Design Study (Preprint)

BACKGROUND In response to the increasing incidence and prevalence of hypertension, Ethiopia has been piloting hypertension control at the primary healthcare level in selected sentinel sites. However, no evaluation has been conducted and its success and failures has not been ascertained. OBJECTIVE This study aimed to evaluate on whether sentinel hypertension surveillance system in Mojo City were operating efficiently and effectively METHODS A concurrently embedded mixed design (quantitative/qualitative) study was conducted in two sentinel health centers in Mojo city, Oromia region of Ethiopia. The usefulness and nine system attributes were assessed via key informant interviews, observations and record reviews. The qualitative data were analyzed manually via thematic analysis, whereas quantitative data were analyzed via SPSS Software version 25.0. RESULTS The study invited 14 key informants, and all were willing to participate in the interview. The completeness and timeliness of reports were 98% and 100%, respectively. The sensitivity, positive predictive value and representativeness were 45.3%, 92.6% and 22%, respectively. Nearly three-fourths (71.4%) of key informants perceived system as flexible, while half thought it as unstable due to factors such as inadequate training and lack of supportive supervision and feedback system. Health facilities didn’t conduct routine data analysis and interpretation nor did they use for action. CONCLUSIONS The surveillance system in Mojo city was simple, flexible, acceptable and predictive but less sensitive, unrepresentative and unstable. There is a need for implementing routine data analysis and use for action, adequate training, and feedback system for optimizing the system's performance and to ensure its sustainability