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Type: Journal article
Title: Assessment of care provision for hypertension at the emergency department of an urban hospital in Mozambique
Author: Bay, N.
Juga, E.
MacUacua, C.
João, J.
Costa, M.
Stewart, S.
Mocumbi, A.
Citation: BMC Health Services Research, 2019; 19(1):975-1-975-8
Publisher: Springer Nature
Issue Date: 2019
ISSN: 1472-6963
Statement of
Neusa Bay, Edna Juga, Carlos Macuacua, José João, Maria Costa, Simon Stewart, and Ana Mocumbi
Abstract: Background: Management of hypertension in Mozambique is poor, and rates of control are amongst the lowest in the world. Health system related factors contribute at least partially to this situation, particularly in settings where there is scarcity of resources to address the double burden of infectious and non-communicable diseases. This study aimed to assess the management of hypertension in an emergency department (ED). Methods: During a pragmatic and prospective 30-day snapshot study (with 24 h surveillance) and random profiling of one-in-five presentations to the ED of Hospital Geral de Mavalane, Maputo, we assessed patient’s flow and care, as well as health facility’s infrastructure and resources through direct observation. Reports from pharmacy and laboratory stocks were used to assess availability of diagnostics and medicines needed for hypertension management. Results: The 1911 hypertensive patients included in the study had several stops during their journey inside the health facility and followed a non-standardized care flow. No clinical protocols or algorithms for risk stratification of hypertension were available. Stock-outs of basic diagnostic tools for risk stratification and medicines were registered. The availability of medicines was 28% on average. Conclusions: Critical gaps in health facility readiness to address arterial hypertension seen in ED were uncovered, including lack of clinical protocols, insufficient availability of diagnostics and essential medicines, as well as low affordability of the families to guaranty continuum of care. Innovative financing mechanisms are needed to support the health system to address hypertension.
Keywords: Systemic hypertension; management cascade; medicine availability; affordability
Rights: © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
DOI: 10.1186/s12913-019-4820-8
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