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BMC Public Health
Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Hypertension | Research

Why is there a gap in self-rated health among people with hypertension in Zambia? A decomposition of determinants and rural‒urban differences

Authors: Chris Mweemba, Wilbroad Mutale, Felix Masiye, Peter Hangoma

Published in: BMC Public Health | Issue 1/2024

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Abstract

Background

Hypertension affects over one billion people globally and is one of the leading causes of premature death. Low- and middle-income countries, especially the sub-Saharan Africa region, bear a disproportionately higher share of hypertension globally. Recent evidence shows a steady shift in the burden of hypertension from more affluent and urban populations towards poorer and rural communities. Our study examined inequalities in self-rated health (SRH) among people with hypertension and whether there is a rural‒urban gap in the health of these patients. We then quantified factors driving the health gap. We also examined how much HIV accounts for differences in self-rated health among hypertension patients due to the relationship between HIV, hypertension and health in sub-Saharan Africa.

Methods

We utilized the Zambia Household Health Expenditure and Utilization Survey for data on SRH and other demographic and socioeconomic controls. District HIV prevalence information was from the Zambia Population-Based HIV Impact Assessment (ZAMPHIA) survey. We applied the Linear Probability Model to assess the association between self-rated health and independent variables as a preliminary step. We then used the Blinder-Oaxaca decomposition to identify self-rated health inequality between urban and rural patients and determine determinants of the health gap between the two groups.

Results

Advanced age, lower education and low district HIV prevalence were significantly associated with poor health rating among hypertension patients. The decomposition analysis indicated that 45.5% of urban patients and 36.9% of rural patients reported good self-rated health, representing a statistically significant health gap of 8.6%. Most of the identified health gap can be attributed to endowment effects, with education (73.6%), district HIV prevalence (30.8%) and household expenditure (4.8%) being the most important determinants that explain the health gap.

Conclusions

Urban hypertension patients have better SRH than rural patients in Zambia. Education, district HIV prevalence and household expenditure were the most important determinants of the health gap between rural and urban hypertension patients. Policies aimed at promoting educational interventions, improving access to financial resources and strengthening hypertension health services, especially in rural areas, can significantly improve the health of rural patients, and potentially reduce health inequalities between the two regions.
Appendix
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Literature
1.
Cao X. A call for global research on non-communicable diseases. Lancet Lond Engl. 2015;385(9967):e5–6.CrossRef
2.
Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, et al. Global disparities of hypertension prevalence and control: a systematic analysis of Population-based studies from 90 countries. Circulation. 2016;134(6):441–50.PubMedPubMedCentralCrossRef
3.
4.
Chen R, Dharmarajan K, Kulkarni VT, Punnanithinont N, Gupta A, Bikdeli B, et al. Most important outcomes Research Papers on Hypertension. Circ Cardiovasc Qual Outcomes. 2013;6(4):e26–35.PubMedPubMedCentralCrossRef
5.
Bloch MJ. Worldwide prevalence of hypertension exceeds 1.3 billion. J Am Soc Hypertens JASH. 2016;10(10):753–4.PubMedCrossRef
6.
Owolabi M, Olowoyo P, Miranda JJ, Akinyemi R, Feng W, Yaria J, et al. Gaps in Hypertension guidelines in low- and Middle Income Versus High Income countries: a systematic review. Hypertens Dallas Tex 1979. 2016;68(6):1328–37.
7.
Gorelick PB. The global burden of stroke: persistent and disabling. Lancet Neurol. 2019;18(5):417–8.PubMedCrossRef
8.
9.
Campbell NR, Lemogoum D. Hypertension in sub-saharan Africa: a massive and increasing health disaster awaiting solution. Cardiovasc J Afr. 2015;26(4):152–4.PubMedPubMedCentral
10.
Antignac M, Diop IB, Macquart de Terline D, Kramoh KE, Balde DM, Dzudie A, et al. Socioeconomic status and hypertension control in Sub-saharan Africa. Hypertension. 2018;71(4):577–84.PubMedCrossRef
11.
Kirschbaum TK, Sudharsanan N, Manne -Goehler, Jennifer, De NJW, Lemp JM, Theilmann M, et al. The Association of Socioeconomic Status with Hypertension in 76 low- and Middle-Income Countries. J Am Coll Cardiol. 2022;80(8):804–17.PubMedCrossRef
12.
Chow CK, Teo KK, Rangarajan S, Islam S, Gupta R, Avezum A, et al. Prevalence, awareness, treatment, and Control of Hypertension in Rural and Urban Communities in High-, Middle-, and low-income countries. JAMA. 2013;310(9):959–68.PubMedCrossRef
13.
Rush KL, Goma FM, Barker JA, Ollivier RA, Ferrier MS, Singini D. Hypertension prevalence and risk factors in rural and urban Zambian adults in western province: a cross-sectional study. Pan Afr Med J. 2018;30:97.PubMedPubMedCentralCrossRef
14.
Samanic CM, Barbour KE, Liu Y, Wang Y, Fang J, Lu H, et al. Prevalence of self-reported hypertension and antihypertensive medication use by County and Rural-Urban classification — United States, 2017. Morb Mortal Wkly Rep. 2020;69(18):533–9.CrossRef
15.
Agyemang C. Rural and urban differences in blood pressure and hypertension in Ghana, West Africa. Public Health. 2006;120(6):525–33.PubMedCrossRef
16.
Gulliford M, Commentary. Epidemiological transition and socioeconomic inequalities in blood pressure in Jamaica. Int J Epidemiol. 2003;32(3):408–9.PubMedCrossRef
17.
Kaufman JS, Owoaje EE, James SA, Rotimi CN, Cooper RS. Determinants of hypertension in West Africa: contribution of anthropometric and dietary factors to urban-rural and socioeconomic gradients. Am J Epidemiol. 1996;143(12):1203–18.PubMedCrossRef
18.
Elias MA, Pati MK, Aivalli P, Srinath B, Munegowda C, Shroff ZC, et al. Preparedness for delivering non-communicable disease services in primary care: access to medicines for diabetes and hypertension in a district in south India. BMJ Glob Health. 2018;2(Suppl 3):e000519.PubMedPubMedCentralCrossRef
19.
Mutale W, Bosomprah S, Shankalala P, Mweemba O, Chilengi R, Kapambwe S, et al. Assessing capacity and readiness to manage NCDs in primary care setting: gaps and opportunities based on adapted WHO PEN tool in Zambia. PLoS ONE. 2018;13(8):e0200994.PubMedPubMedCentralCrossRef
20.
Kabir A, Karim MN, Islam RM, Romero L, Billah B. Health system readiness for non-communicable diseases at the primary care level: a systematic review. BMJ Open. 2022;12(2):e060387.PubMedPubMedCentralCrossRef
21.
Tateyama Y, Techasrivichien T, Musumari PM, Suguimoto SP, Ongosi AN, Zulu R, et al. Hypertension, its correlates and differences in access to healthcare services by gender among rural Zambian residents: a cross-sectional study. BMJ Open. 2022;12(4):e055668.PubMedPubMedCentralCrossRef
22.
Goma FM, Nzala SH, Babaniyi O, Songolo P, Zyaambo C, Rudatsikira E, et al. Prevalence of hypertension and its correlates in Lusaka urban district of Zambia: a population based survey. Int Arch Med. 2011;4:34.PubMedPubMedCentralCrossRef
23.
Mishra SR, Ghimire S, Shrestha N, Shrestha A, Virani SS. Socio-economic inequalities in hypertension burden and cascade of services: nationwide cross-sectional study in Nepal. J Hum Hypertens. 2019;33(8):613–25.PubMedCrossRef
24.
Moser KA, Agrawal S, Smith GD, Ebrahim S. Socio-demographic inequalities in the prevalence, diagnosis and management of hypertension in India: analysis of nationally-Representative Survey Data. PLoS ONE. 2014;9(1):e86043.PubMedPubMedCentralCrossRef
25.
Jeon YJ, Kim CR, Park JS, Choi KH, Kang MJ, Park SG, et al. Health inequalities in hypertension and diabetes management among the poor in urban areas: a population survey analysis in South Korea. BMC Public Health. 2016;16(1):492.PubMedPubMedCentralCrossRef
26.
de Gaudemaris R, Lang T, Chatellier G, Larabi L, Lauwers-Cancès V, Maître A, et al. Socioeconomic inequalities in hypertension prevalence and care: the IHPAF Study. Hypertens Dallas Tex 1979. 2002;39(6):1119–25.
27.
van den Berg G, van Eijsden M, Galindo-Garre F, Vrijkotte TGM, Gemke RJBJ. Explaining socioeconomic inequalities in Childhood Blood pressure and prehypertension. Hypertension. 2013;61(1):35–41.PubMedCrossRef
28.
29.
30.
Cislaghi B, Cislaghi C. Self-rated health as a valid indicator for health-equity analyses: evidence from the Italian health interview survey. BMC Public Health. 2019;19(1):533.PubMedPubMedCentralCrossRef
31.
Vie TL, Hufthammer KO, Holmen TL, Meland E, Breidablik HJ. Is self-rated health a stable and predictive factor for allostatic load in early adulthood? Findings from the Nord Trøndelag Health Study (HUNT). Soc Sci Med. 2014;117:1–9.PubMedCrossRef
32.
Wu S, Wang R, Zhao Y, Ma X, Wu M, Yan X, et al. The relationship between self-rated health and objective health status: a population-based study. BMC Public Health. 2013;13(1):320.PubMedPubMedCentralCrossRef
33.
Shankar A, Wang JJ, Rochtchina E, Mitchell P. Association between self-rated health and incident severe hypertension among men: a population-based cohort study. Singap Med J. 2008;49(11):860–7.
34.
35.
36.
Hong TB, Oddone EZ, Dudley TK, Bosworth HB. Subjective and objective evaluations of health among middle-aged and older veterans with hypertension. J Aging Health. 2005;17(5):592–608.PubMedCrossRef
37.
Song X, Wu J, Yu C, Dong W, Lv J, Guo Y, et al. Association between multiple comorbidities and self-rated health status in middle-aged and elderly Chinese: the China Kadoorie Biobank study. BMC Public Health. 2018;18(1):744.PubMedPubMedCentralCrossRef
38.
Uchino BN, Birmingham W, Landvatter J, Cronan S, Scott E, Smith TW. Self-Rated Health and Age-related differences in ambulatory blood pressure: the mediating role of behavioral and affective factors. Psychosom Med. 2020;82(4):402–8.PubMedPubMedCentralCrossRef
39.
Shin HY, Shin MH, Rhee JA. Gender differences in the association between self-rated health and hypertension in a Korean adult population. BMC Public Health. 2012;12:135.PubMedPubMedCentralCrossRef
40.
41.
Alvarez-Galvez J, Rodero-Cosano ML, Motrico E, Salinas-Perez JA, Garcia-Alonso C, Salvador-Carulla L. The impact of Socio-Economic Status on Self-Rated Health: study of 29 countries using European social surveys (2002–2008). Int J Environ Res Public Health. 2013;10(3):747–61.PubMedPubMedCentralCrossRef
42.
Yang H, Deng Q, Geng Q, Tang Y, Ma J, Ye W, et al. Association of self-rated health with chronic disease, mental health symptom and social relationship in older people. Sci Rep. 2021;11(1):14653.PubMedPubMedCentralCrossRef
43.
McDaid O, Hanly MJ, Richardson K, Kee F, Kenny RA, Savva GM. The effect of multiple chronic conditions on self-rated health, disability and quality of life among the older populations of Northern Ireland and the Republic of Ireland: a comparison of two nationally representative cross-sectional surveys. BMJ Open. 2013;3(6):e002571.PubMedPubMedCentralCrossRef
44.
45.
Okeke NL, Davy T, Eron JJ, Napravnik S. Hypertension among HIV-infected patients in Clinical Care, 1996–2013. Clin Infect Dis off Publ Infect Dis Soc Am. 2016;15(2):242–8.CrossRef
46.
Palacios R, Santos J, García A, Castells E, González M, Ruiz J, et al. Impact of highly active antiretroviral therapy on blood pressure in HIV-infected patients. A prospective study in a cohort of naive patients. HIV Med. 2006;7(1):10–5.PubMedCrossRef
47.
Seaberg EC, Muñoz A, Lu M, Detels R, Margolick JB, Riddler SA, et al. Association between highly active antiretroviral therapy and hypertension in a large cohort of men followed from 1984 to 2003. AIDS Lond Engl. 2005;19(9):953–60.CrossRef
48.
van Zoest RA, van den Born BJH, Reiss P. Hypertension in people living with HIV. Curr Opin HIV AIDS. 2017;12(6):513–22.PubMedCrossRef
49.
van Zoest RA, Wit FW, Kooij KW, van der Valk M, Schouten J, Kootstra NA, et al. Higher prevalence of hypertension in HIV-1-Infected patients on combination antiretroviral therapy is Associated with changes in body composition and prior stavudine exposure. Clin Infect Dis. 2016;63(2):205–13.PubMedCrossRef
50.
Xu Y, Chen X, Wang K. Global prevalence of hypertension among people living with HIV: a systematic review and meta-analysis. J Am Soc Hypertens JASH. 2017;11(8):530–40.PubMedCrossRef
51.
52.
53.
Cappuccio FP, Miller MA. Cardiovascular disease and hypertension in sub-saharan Africa: burden, risk and interventions. Intern Emerg Med. 2016;11:299–305.PubMedPubMedCentralCrossRef
54.
World Health Organization. Handbook on health inequality monitoring with a special focus on low- and middle-income countries. World Health Organization; 2013.
55.
Hosseinpoor AR, Bergen N, Schlotheuber A, Boerma T. National health inequality monitoring: current challenges and opportunities. Glob Health Action. 2018;11(sup1):1392216.PubMedPubMedCentral
56.
Ministry of Health. The 2012 Annual Health Statistical Bulletin. Lusaka, Zambia: Ministry of Health Directorate of Policy and Planning, Monitoring and Evaluation Unit; 2014.
57.
Clarke-Deelder E, Afriyie DO, Nseluke M, Masiye F, Fink G. Health care seeking in modern urban LMIC settings: evidence from Lusaka, Zambia. BMC Public Health. 2022;22:1205.PubMedPubMedCentralCrossRef
58.
59.
60.
Hangoma P, Robberstad B, Aakvik A. Does Free Public Health Care increase utilization and reduce spending? Heterogeneity and Long Term effects. World Dev. 2018;101:334–50.PubMedCrossRef
61.
62.
63.
Hangoma P, Aakvik A, Robberstad B. Health Shocks and Household Welfare in Zambia: an Assessment of changing risk. J Int Dev. 2018;30(5):790–817.CrossRef
64.
Ministry of Health. Zambia Household Health Expenditure and Utilization Survey (ZHHEUS): Final Report. 2015. 150 p.
65.
66.
Sinning M, Hahn M, Bauer TK. The Blinder–Oaxaca decomposition for nonlinear regression models. Stata J. 2008;8(4):480–92.CrossRef
67.
Ministry of Health, Zambia. Zambia Population-based HIV Impact Assessment (ZAMPHIA) 2016: First Report. Zambia. 2017.
68.
van Zoest RA, Wit FW, Kooij KW, van der Valk M, Schouten J, Kootstra NA, et al. Higher prevalence of hypertension in HIV-1-Infected patients on combination antiretroviral therapy is Associated with changes in body composition and prior stavudine exposure. Clin Infect Dis off Publ Infect Dis Soc Am. 2016;63(2):205–13.CrossRef
69.
Dimala CA, Blencowe H. Association between highly active antiretroviral therapy and selected cardiovascular disease risk factors in sub-saharan Africa: a systematic review and meta-analysis protocol. BMJ Open. 2017;7(3):e013353.PubMedPubMedCentralCrossRef
70.
StataCorp L. Stata survey data reference manual. Citeseer. 1985.
71.
Hangoma P, Aakvik A, Robberstad B. Explaining changes in child health inequality in the run up to the 2015 Millennium Development Goals (MDGs): the case of Zambia. PLoS ONE. 2017;12(2):e0170995.PubMedPubMedCentralCrossRef
72.
Chatla S, Shmueli G. Linear Probability models (LPM) and Big Data: the Good, the bad, and the Ugly. SSRN Electron J. 2013.
73.
Rezaei S, Hajizadeh M, Salimi Y, Moradi G, Nouri B. What explains socioeconomic inequality in Health-related quality of life in Iran? A Blinder-Oaxaca decomposition. J Prev Med Pub Health. 2018;51(5):219–26.CrossRef
74.
Shmueli G, Chatla S. Linear probability models in information systems research. ECIS. 2014 Proc– 22nd Eur Conf Inf Syst. 2014.
75.
Heckman JJ, Snyder JM. Linear Probability models of the demand for attributes with an empirical application to estimating the preferences of legislators. RAND J Econ. 1997;28:S142–89.CrossRef
76.
Friedman J, Schady N. How many infants likely died in Africa as a result of the 2008–2009 Global Financial Crisis? Health Econ. 2013;22(5):611–22.PubMedCrossRef
77.
Kröger H. The contribution of health selection to occupational status inequality in Germany– differences by gender and between the public and private sectors. Public Health. 2016;133:67–74.PubMedCrossRef
78.
Bauer TK, Sinning M. An extension of the Blinder–Oaxaca decomposition to nonlinear models. AStA Adv Stat Anal. 2008;92(2):197–206.CrossRef
79.
80.
81.
Wooldridge JM. Introductory econometrics: a Modern Approach. Cengage Learning; 2015. p. 789.
82.
Wooldridge JM. Econometric analysis of cross section and panel data. MIT Press; 2010.
83.
StataCorp, Stata. Release 14. Statistical Software. 2015.
84.
Owen O’Donnell, van Doorslaer E, Wagstaff A, Lindelow M. Analyzing Health Equity using Household Survey data: a guide to techniques and their implementation. Washington, DC: World Bank. © World Bank; 2008.
85.
Fairlie RW. An extension of the Blinder-Oaxaca decomposition technique to logit and probit models. J Econ Soc Meas. 2005;30(4):305–16.CrossRef
86.
Khadr Z. Monitoring the decomposition of wealth-related inequality in the use of regular antenatal care in Egypt (1995–2014). BMC Public Health. 2020;20(1):1307.PubMedPubMedCentralCrossRef
87.
Borgonovi F, Pokropek A. Education and self-reported health: evidence from 23 countries on the role of years of schooling, cognitive skills and Social Capital. PLoS ONE. 2016;11(2):e0149716.PubMedPubMedCentralCrossRef
88.
Gatimu SM, John TW. Socioeconomic inequalities in hypertension in Kenya: a decomposition analysis of 2015 Kenya STEPwise survey on non-communicable diseases risk factors. Int J Equity Health. 2020;19(1):213.PubMedPubMedCentralCrossRef
89.
Ma C, Zhou W, Huang C, Huang S. A cross-sectional survey of self-rated health and its determinants in patients with hypertension. Appl Nurs Res. 2015;28(4):347–51.PubMedCrossRef
90.
de Loyola Filho AI, Firmo J, de OA, Uchôa E, Lima-Costa MF. Associated factors to self-rated health among hypertensive and/or diabetic elderly: results from Bambuí project. Rev Bras Epidemiol. 2013;16:559–71.PubMedCrossRef
91.
Jufar A, Nuguse F, Misgna H. Assessment of health related quality of life and associated factors among hypertensive patients on treatment at public hospitals in Mekelle, North Ethiopia. J Hypertens. 2017;6(1):1000239.
92.
Galama TJ, Lleras-Muney A, van Kippersluis H. The Effect of Education on Health and Mortality: A Review of Experimental and Quasi-Experimental Evidence. [Internet]. National Bureau of Economic Research; 2018 Jan [cited 2022 Feb 14]. Report No.: 24225. https://​www.​nber.​org/​papers/​w24225
93.
94.
Zhang Y, Zhou Z, Gao J, Wang D, Zhang Q, Zhou Z, et al. Health-related quality of life and its influencing factors for patients with hypertension: evidence from the urban and rural areas of Shaanxi Province, China. BMC Health Serv Res. 2016;16(1):277.PubMedPubMedCentralCrossRef
95.
Raghupathi V, Raghupathi W. The influence of education on health: an empirical assessment of OECD countries for the period 1995–2015. Arch Public Health. 2020;78(1):20.PubMedPubMedCentralCrossRef
96.
Du S, Zhou Y, Fu C, Wang Y, Du X, Xie R. Health literacy and health outcomes in hypertension: an integrative review. Int J Nurs Sci. 2018;5(3):301–9.PubMedPubMedCentral
97.
Huang Y, Qi F, Wang R, Jia X, Wang Y, Lin P, et al. The effect of health literacy on health status among residents in Qingdao, China: a path analysis. Environ Health Prev Med. 2021;26(1):78.PubMedPubMedCentralCrossRef
98.
Shi D, Li J, Wang Y, Wang S, Liu K, Shi R, et al. Association between health literacy and hypertension management in a Chinese community: a retrospective cohort study. Intern Emerg Med. 2017;12(6):765–76.PubMedCrossRef
99.
Wang C, Lang J, Xuan L, Li X, Zhang L. The effect of health literacy and self-management efficacy on the health-related quality of life of hypertensive patients in a western rural area of China: a cross-sectional study. Int J Equity Health. 2017;16(1):58.PubMedPubMedCentralCrossRef
100.
Perez A, Acculturation. Health Literacy, and illness perceptions of hypertension among hispanic adults. J Transcult Nurs off J Transcult Nurs Soc. 2015;26(4):386–94.CrossRef
101.
Gorman BK, Sivaganesan A. The role of social support and integration for understanding socioeconomic disparities in self-rated health and hypertension. Soc Sci Med. 2007;65(5):958–75.PubMedCrossRef
102.
Goli S, Singh L, Jain K, Pou LMA. Socioeconomic determinants of Health inequalities among the older Population in India: a decomposition analysis. J Cross-Cult Gerontol. 2014;29(4):353–69.PubMedCrossRef
103.
Alaba OA, Hongoro C, Thulare A, Lukwa AT. Leaving no child behind: decomposing socioeconomic inequalities in Child Health for India and South Africa. Int J Environ Res Public Health. 2021;18(13):7114.PubMedPubMedCentralCrossRef
104.
Omotoso KO, Koch SF. Assessing changes in social determinants of health inequalities in South Africa: a decomposition analysis. Int J Equity Health. 2018;17(1):181.PubMedPubMedCentralCrossRef
105.
Goetjes E, Pavlova M, Hongoro C, Groot W. Socioeconomic inequalities and obesity in South Africa—A decomposition analysis. Int J Environ Res Public Health. 2021;18(17):9181.PubMedPubMedCentralCrossRef
106.
Van Malderen C, Amouzou A, Barros AJD, Masquelier B, Van Oyen H, Speybroeck N. Socioeconomic factors contributing to under-five mortality in sub-saharan Africa: a decomposition analysis. BMC Public Health. 2019;19(1):760.PubMedPubMedCentralCrossRef
107.
Brugha R, Simbaya J, Walsh A, Dicker P, Ndubani P. How HIV/AIDS scale-up has impacted on non- HIV priority services in Zambia. BMC Public Health. 2010;10(1):540.PubMedPubMedCentralCrossRef
108.
Yu D, Souteyrand Y, Banda MA, Kaufman J, Perriëns JH. Investment in HIV/AIDS programs: does it help strengthen health systems in developing countries? Glob Health. 2008;4(1):8.CrossRef
109.
Embrey M, Hoos D, Quick J. How AIDS funding strengthens health systems: progress in pharmaceutical management. J Acquir Immune Defic Syndr. 1999. 2009;52 Suppl 1:S34-37.
110.
111.
Lazarus JV, Safreed-Harmon K, Barton SE, Costagliola D, Dedes N, del Amo Valero J, et al. Beyond viral suppression of HIV– the new quality of life frontier. BMC Med. 2016;14(1):94.PubMedPubMedCentralCrossRef
112.
Nakazwe C, Michelo C, Sandøy IF, Fylkesnes K. Contrasting HIV prevalence trends among young women and men in Zambia in the past 12 years: data from demographic and health surveys 2002–2014. BMC Infect Dis. 2019;19(1):432.PubMedPubMedCentralCrossRef
113.
Meiqari L, Nguyen TPL, Essink D, Zweekhorst M, Wright P, Scheele F. Access to hypertension care and services in primary health-care settings in Vietnam: a systematic narrative review of existing literature. Glob Health Action. 2019;12(1):1610253.PubMedPubMedCentralCrossRef
114.
Laar AK, Adler AJ, Kotoh AM, Legido-Quigley H, Lange IL, Perel P, et al. Health system challenges to hypertension and related non-communicable diseases prevention and treatment: perspectives from Ghanaian stakeholders. BMC Health Serv Res. 2019;19(1):693.PubMedPubMedCentralCrossRef
115.
Palma A, Rabkin M, Nuwagaba-Biribonwoha H, Bongomin P, Lukhele N, Dlamini X, et al. Can the success of HIV Scale-Up Advance the Global Chronic Non-communicable Disease Agenda? Glob Heart. 2016;11(4):403–8.PubMedCrossRef
116.
Madela S, Harriman N, Sewpaul R, Mbewu A, Williams D, Sifunda S, et al. Individual and area-level socioeconomic correlates of hypertension prevalence, awareness, treatment, and control in uMgungundlovu, KwaZulu-Natal, South Africa. BMC Public Health. 2023;23(1):417.PubMedPubMedCentralCrossRef
117.
118.
Abdulraheem IS. Experience and perspectives of quality of health care in Nigerian rural community: an exploratory study. Niger Med Pract. 2007;50(2):48–53.
119.
Cappuccio FP, Micah FB, Emmett L, Kerry SM, Antwi S, Martin-Peprah R, et al. Prevalence, detection, management, and Control of Hypertension in Ashanti, West Africa. Hypertension. 2004;43(5):1017–22.PubMedCrossRef
120.
Camacho PA, Gomez-Arbelaez D, Molina DI, Sanchez G, Arcos E, Narvaez C, et al. Social disparities explain differences in hypertension prevalence, detection and control in Colombia. J Hypertens. 2016;34(12):2344–52.PubMedCrossRef
121.
Li W, Gu H, Teo KK, Bo J, Wang Y, Yang J, et al. Hypertension prevalence, awareness, treatment, and control in 115 rural and urban communities involving 47 000 people from China. J Hypertens. 2016;34(1):39–46.PubMedCrossRef
122.
Jongen VW, Lalla-Edward ST, Vos AG, Godijk NG, Tempelman H, Grobbee DE, et al. Hypertension in a rural community in South Africa: what they know, what they think they know and what they recommend. BMC Public Health. 2019;19(1):341.PubMedPubMedCentralCrossRef
123.
Aryeetey GC, Westeneng J, Spaan E, Jehu-Appiah C, Agyepong IA, Baltussen R. Can health insurance protect against out-of-pocket and catastrophic expenditures and also support poverty reduction? Evidence from Ghana’s National Health Insurance Scheme. Int J Equity Health. 2016;15(1):116.PubMedPubMedCentralCrossRef
124.
125.
Kwan GF, Yan LD, Isaac BD, Bhangdia K, Jean-Baptiste W, Belony D, et al. High poverty and hardship financing among patients with noncommunicable diseases in Rural Haiti. Glob Heart. 2020;15(1):7.PubMedPubMedCentralCrossRef
126.
Fateh M, Emamian MH, Asgari F, Alami A, Fotouhi A. Socioeconomic inequality in hypertension in Iran. J Hypertens. 2014;32(9):1782–8.PubMedCrossRef
127.
Hosseinpoor AR, Van Doorslaer E, Speybroeck N, Naghavi M, Mohammad K, Majdzadeh R, et al. Decomposing socioeconomic inequality in infant mortality in Iran. Int J Epidemiol. 2006;35(5):1211–9.PubMedCrossRef
128.
Epstein MJ, Yuthas K. Scaling Effective Education for the poor in developing countries: a report from the field. J Public Policy Mark. 2012;31(1):102–14.CrossRef
129.
130.
Rabkin M, El-Sadr WM. Why reinvent the wheel? Leveraging the lessons of HIV scale-up to confront non-communicable diseases. Glob Public Health. 2011;6(3):247–56.PubMedCrossRef
131.
Mutale W, Balabanova D, Chintu N, Mwanamwenge MT, Ayles H. Application of system thinking concepts in health system strengthening in low-income settings: a proposed conceptual framework for the evaluation of a complex health system intervention: the case of the BHOMA intervention in Zambia. J Eval Clin Pract. 2016;22(1):112–21.PubMedCrossRef
Metadata
Title
Why is there a gap in self-rated health among people with hypertension in Zambia? A decomposition of determinants and rural‒urban differences
Authors
Chris Mweemba
Wilbroad Mutale
Felix Masiye
Peter Hangoma
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-18429-6

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Assessing urogenital schistosomiasis and female genital schistosomiasis (FGS) among adolescents in Anaocha, Anambra State, Nigeria: implications for ongoing control efforts

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Health-promoting behaviors in older adulthood and intrinsic capacity 10 years later: the HUNT study

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Synergistic associations of antenatal care visits and iron-folic acid supplementation with low birth weight: a pooled analysis of national surveys from six south Asian countries

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Spatial multi-criteria decision analysis for the selection of sentinel regions in tick-borne disease surveillance

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A qualitative synthesis of practice-based learning from case studies on COVID community champion programmes in England, UK