Table 4. Facilitators and Barriers in Providing Hypertension Diagnosis Services Across Different Levels of Health Facilities, Wakiso District, Uganda, 2019.

Health facility level	Facilitators to hypertension diagnosis services	Barriers to hypertension diagnosis services
Hospitala	• Medical training • Equipment availability • Clinical experience • Continuous medical education	• Lack consistent funding for village follow-ups • Patients miss scheduled appointments • Difficulties in measuring height of women with plaited hair • Lack measures to investigate other comorbidities • Resistance from patients to take measurements
Health Centre IVb	• Equipment availability • Implementing partners • History-taking and assessments of hypertension diseases in the patient’s family • Continuous medical education	• Lack supplies or batteries for digital equipment • Lack measures of investigation of other comorbidities • Faulty equipment • Lack consistent funding for village follow-ups • Contradicting information on hypertension from different guidelines
Health Centre IIIc	• Equipment availability • Clinical experience • History-taking and assessments of hypertension diseases in the patient’s family • Medical training • Guidelines • Triage of patients • Responsive patients • Continuous medical education • On-the-job training • Hypertension treatment cards • Presence of other health workers who provide mentorship	• Lack consistent funding for village follow-ups • Faulty equipment • Resistance from patients to take measurements • Patients miss scheduled appointments • Lack supplies or batteries for digital equipment • Blood pressure cuffs do not fit patients’ arms • Blood pressure apparatus rarely calibrated • Time-consuming to take several measurements • Lack measures to investigate other comorbidities • Difficult to use the manual blood pressure machine • Lack of hypertension cards • Uncertainty about referrals made for patients to reach higher-level health facilities • Lack of equipment
Health Centre IId	• Equipment availability • History-taking and assessments of hypertension diseases in the patient’s family • Clinical experience • Implementing partners • Triage of patients • Responsive patients • Medical training	• Uncertainty about referrals made for patients to reach higher-level health facilities • Faulty equipment • Lack supplies or batteries for digital equipment • Lack consistent funding for village follow-ups • Patients miss scheduled appointments • Blood pressure cuffs do not fit patient’s arm • Difficult to use the manual blood pressure machine

^a Found at district level and offers all services offered at HCIVs, plus service training, consultation, and research to a population of approximately 500,000.

^b Found at the county level and offers all services offered at HCIIIs, plus emergency surgery and blood transfusion to a population of approximately 100,000.

^c Found at the subcounty level and offers all services offered at HCIIs, plus maternity, inpatient, and laboratory services to a population of approximately 20,000.

^d Found at the parish level and offers preventive, promotive, outpatient curative health services, outreach care, and emergency services to a population of approximately 5,000.