Preliminary Understanding of Hypertensive Clinics and Hypertensive Patients Attending Hypertensive Clinics in Malawi
Authors: Siyame Edwin WP , Goodell L. Suzanne , Allen Jonathan C. 
Published: November 2023

Malawi is a developing country that is experiencing significant nutrition transition. There is an increase in consumption of foods that are high in salt, sugar and fatty acids due to changes in peoples’ income and urban migration. Improved use of technology has further resulted in decreased physical activity and as a result hypertension and other dietary related non‐communicable diseases are also on the increase. At the moment, sparse research that has been conducted reveals that 33% of the population is hypertensive.

Our objective was to evaluate the practices in hypertensive clinics in Malawi with the aim of improving nutritional guidance. With funding from USAID through the Feed the Future program, preliminary qualitative research was conducted in the four central hospitals (Zomba, Queen Elizabeth, Kamuzu and Mzuzu) in Malawi between June and July 2015 with the objective of understanding the hypertensive clinic setup, number of patients attending the clinic, nurses and clinical officers availability in the clinics, patients’ record keeping and general characteristics of patients (location of residence and gender). One Clinical Officer/Nurse was interviewed per hospital (n=4) after obtaining permission from the hospital director.

Analysis of notes taken during interviews and field notes recorded after interviews revealed no dietary guidelines for hypertension management, little or no resources (either financial or human resources) to manage and treat hypertension, an increasing number of hypertensive patients in need of help, and that the problem is also affecting people in rural areas more than initially thought. These problems are increasing the pressure on Malawi's health system to find and allocate more resources to improve the well being of Malawians.

Interviewees reported that on average 10 people are admitted to hypertensive clinic every clinic session and that there are more females being admitted than males. This could reflect greater health‐seeking behavior in females than males. Interviewees reported limited knowledge in the management of hypertension and other non‐communicable diseases. Hypertensive patient management is complicated by a co‐existence of hypertension and diabetes among most patients. Poor record keeping, with a mixture of hard copies and electronic records, was observed, which makes it difficult to follow up with patients and maintain continuity of care.

There is need to initiate affordable, feasible and cost‐effective interventions to prevent and manage hypertension. Research can be conducted in the four central hospitals of Malawi to characterize dietary practices of hypertensive patients attending hypertensive clinics. Better understanding of the effectiveness of dietary advice that is currently given to hypertensive patients is needed. New dietary guidelines to manage hypertension and improve health education delivery should be produced.

Support or Funding Information

Supported by USAID funds through CIMMYT and Michigan State University under the BHEARD program. Findings, opinions and recommendations are those of the author and not necessarily those of USAID, MSU, CIMMYT or NCSU.