Table 2. Summary of Literature Reviewed.

Author	Setting and Sample Size	Study Design	Detailed Hypertension-related Findings
Hendriks et al. (2014)	Nigeria, community dwelling adults, n = 3,023	Cohort (24 month follow up)	Hypertension Control: Systolic blood pressure decreased by 10.41 (95% CI, -13.28 to -7.54) mm Hg among patients in the community-based health insurance program (CBHI). Diastolic blood pressure decreased by 4.27 (95% CI, -5.74 to -2.80) mm Hg in the program area
Peck et al., 2014	Tanzania, n = 335 health care workers	Cross-sectional	Hypertension Treatment: First-line drugs for hypertension were frequently lacking. Basic diagnostic equipment for hypertension was consistently present in 63–75% of health facilities, but even hospital outpatient departments sometimes did not have essential instruments such as sphygmomanometers.
Ndou et al., 2013	South Africa, n = 214 patients	Mixed-methods	Hypertension Control by Community Health Workers in 21.4% of Kgatelopele (community-participants) patients (12/56) were controlled at >40% of health checks in comparison to 13.1% of clinic patients (22/168).
Ambaw et al., 2012	Ethiopia, n = 384 participants in Addis Abba	Cross-sectional	Hypertension Treatment: As the distance from the hospital decreased, the adherence to treatment of HTN improved (AOR = 2.02, 95% CI = 1.19, 3.43).
Ilesanmi et al., 2012	Nigeria, n = 250 rural patients	Cross-sectional	Hypertension Treatment: Mean cost of treatment was ₦1440 ± 560 ($9.6 ± 3.7) with 52.8% spending ≥ 10% of their income on treatment.
Mbouemboue et al. (2012)	Cameroon, n = 117 hypertensive patients in Adamawa region	Cross-sectional	Hypertension awareness (baseline 1 for low cost of medications); medium cost 0.35 [0.06–2.07]; high cost 0.44 [0.07–2.75]
Labhardt et al., 2011	Cameroon, n = 221 patients	RCT	Hypertension Control: Among the 104 hypertensive patients retained at 1 year, 72 (69%) had a BP of 140⁄90 mmHg at the last visit. Overall average systolic BP decreased from 175.8 to 135.6 mmHg (95% CI: 35.0–45.4, P< 0.001) and diastolic from 100.7 to 80.1 (17.3–23.9; P<0.001). Financial incentives added relevant costs to the program. The average monthly cost to patients for antihypertensive medication was €1.10 ± 0.9. The average transport cost among these patients was €1 ± 1.
Osamor et al., 2011	Nigeria, n = 440	Cross-sectional	Medication Compliance: 51% of the subjects reported high compliance with antihypertensive medication. Among respondents with low compliance, they perceived antihypertensive medications to be necessary but indicated that costs of medication among other factors hindered compliance. The medications were expensive compared to income, and some participants could only buy the quantity of medication they could afford instead of the full prescription (for example, two weeks instead of four weeks).
Parker et al., 2011	South Africa, n = 16 physicians	Cross-sectional	Hypertension Treatment: Ten (62.5%) of the doctors surveyed aimed to treat hypertension to target, and recommendations on lifestyle modifications were reportedly poorly done. While 11 (68.8%) of the doctors were aware of the South African hypertension guidelines, were (81.8%) of them were not conversant with the contents thereof. Doctors estimated that only 35% of their patients are treated to target.
Labhardt et al., 2010	Cameroon, Central region, n = 493 hypertensive patients with at least one documented follow-up visit at a non-physician clinician facility (NPC)	Cohort study-before and after intervention, no control group	Hypertension Control: Fall in BP from baseline to follow up. the BP-decrease remained significant: -26.5 mmHg (95%CI: -12.5 to -40.5) for systolic and -17.2 mmHg (95%CI: -7.1 to -27.3) for diastolic BP.
Kengne et al. 2009	Cameroon, Yaounde (urban) and Bafut (rural), n = 454 patients in a nurse-led protocol	Cohort, 24 month follow up	Hypertension Control: Between baseline and final visits, systolic and diastolic blood pressures dropped by 11.7 mm Hg (95% confidence interval, 8.9–14.4) and 7.8 (95% confidence interval, 5.9–9.6), respectively (P < .001).
Gombet et al., 2009	Congo, n = 197 patients in Brazzaville	Cross-sectional Retrospective	Hypertension Control: The overall cost of hypertension emergency care ranged from 74.600 to 18.4600 CFA francs (111.90 to 276.90 euros), i.e., a mean per-patient cost of 159.600 +/-44.107 CFA francs (239.40 +/- 66.20 Euros).Most people living in Brazzaville cannot afford hypertensive emergency
Rayner et al., 2009,	South Africa, n = 451 patients	Cross-sectional	Hypertension Control: BP was reduced by 26.4/17.6 mmHg (p < 0.001) in 220 patients with a documented initial BP. Co-morbidities were present in 322 (71.4%) patients and overall, 37.9% had more than one co-morbidity. Lifestyle modification was not uniformly applied, with only 46.1, 59.6 and 56.8% receiving advice about weight loss, exercise and diet, respectively
Bradley et al., 2007	South Africa, n = 43 community health workers in Khayelithsha	Qualitative methods	Hypertension Awareness: Lack of knowledge about hypertension and it’s risk factors among community health workers
Dennison et al., 2007	South Africa, n = 403 peri-urban blacks	Cross-sectional	Hypertension Control: No significant effect of provider type on systolic BP control below threshold (>140 mmHg systolic and >90 mmHg diastolic BP); Diastolic BP 3.29 mmHg greater in public versus private
Kagee et al., 2007	South Africa, n = 23 participants from Western Cape.	Qualitative methods	Medication Adherence: Participants noted that financial barriers related to travelling to clinic, missing a day’s wage due to clinic visit, and costs of clinic fees and medication influenced adherence to medication. Also, long waiting times at clinic and long travelling distance.
Thorogood et al., 2007	South Africa, n = 105 participants, Agincourt sub-district	Mixed-methods	Hypertension Treatment and Control: Clinic nurses discussed problems with the availability of drugs in the clinics. They either had to deny treatment to patients or switch the treatment to another drug, both actions that are likely to reduce adherence to medication. Nurses also said that they were often unable to monitor blood pressure levels in those with hypertension due to lack of equipment in the clinics and many sphygmomanometers were not functioning at all
Ono et al., 2006	Nigeria, n = 64 patients in southwest region	Cohort (3 year follow up)	Hypertension Treatment: There was a tendency to place patients on monotherapy or "no drug treatment" with successive repeat visits to the clinic, even in cases of uncontrolled systolic blood pressure, as well as declining prescription of moderately aggressive combination therapy as patients revisited the clinic. Isolated systolic hypertension (ISH) patients who received "no drug treatment" on occasions after enrollment were either in borderline stage 1 ISH (33.3%) or in stage 1 ISH (66.7%).
Yusuf et al., 2005	Nigeria, n = 200 patients, in Ibadan	Cross-sectional Retrospective	Medication Adherence: Patient adherence with therapy was documented as adequate in 77.5% (107) of cohort. Adverse drug reactions were documented, by physicians, in only 10.9% (15) of cohort. There appear to be currently no organized institutional adverse drug reaction monitoring, detection and documentation system in place.
Buabeng et al., 2004	Ghana, n = 128 patients at the Komfo Anokye Teaching Hospital	Qualitative methods	Medication Adherence: 93% of the interviewed patients did not comply with their medications. 96% of the non-compliant patients cited unaffordable drug prices as the main reason for non-compliance.
Mendis et al., 2004	Nigeria, n = 1000 hypertensive patients attending. 56 randomly selected primary- (n = 42) and secondary-level (n = 2) health-care and private health-care (n = 12) facilities.	Cross-sectional	Hypertension Awareness, Treatment, and Control: Laboratory and other investigations to exclude secondary hypertension or to assess target organ damage were not available in the majority of facilities, particularly in primary care. A considerable knowledge and awareness gap related to hypertension and its complications was found, both among patients and health-care providers. Blood pressure control rates were poor (28% with systolic blood pressure (SBP) < 140 mmHg and diastolic blood pressure (DBP) < 90 mmHg] and drug prescription patterns were not evidence based and cost effective. The majority of patients (73%) in this low socio-economic group (mean monthly income 73 US dollars) had to pay fully, out of their own pocket, for consultations and medications.
Salako et al., 2003	Nigeria, n = 143 patients,	Cross-sectional	Hypertension Treatment and Control: 51 (36%) of the subjects described as being fully controlled on the treatment instituted while 54 (38%) of the subjects were not controlled at all. In about 18% of the patients, the systolic blood pressure alone was controlled while in 8% the diastolic blood pressure alone was controlled. Furthermore, level of blood pressure control in this study is poor suggesting that availability of free drug alone is not enough to improve adherence to antihypertensives.
Daniels et al., 2000	South Africa, N = 4 community health care centers, 15 physicians and 10 nurses IN Western Cape	Qualitative methods	Hypertension Treatment: Treatment guidelines were not systematically implemented at local CHCs and individual doctors consulted the guidelines infrequently. Several themes were identified as barriers to the application of the guidelines, including the consultation process by which the guidelines were developed, time constraints, skepticism about durability of the guidelines, conflict with local practices, health system problems, and patient beliefs.
Steyn et al., 1999	South Africa, n = 202 patients in Cape town	Cross-sectional	Hypertension Control: 41.6% had a BP above 160/95 mm Hg and only 42.1% had a BP below 140/90 mm Hg. Patients had little knowledge of either the consequences of hypertension or the actions needed to ensure that complications were prevented; 31% suggested home remedies for hypertension. The majority of the patients were satisfied with the service they received, but 47% complained about long waiting times, 37% felt that the doctor did not examine them adequately, and 15.5% reported that insufficient medication was provided when filling prescriptions.
Olubodun et al., 1995	Nigeria, n = 42 physicians	Cross-sectional	Hypertension Control: Over half do not usually measure the blood pressure (BP) of all new patients. A third do not investigate before starting therapy. Over half commence drug therapy with less than three BP readings, while over two thirds do so from appropriate BP levels.