Prevalence and Barriers to Hypertension Management among Residents in Hagadera Refugee Camp (Kenya)

Abstract

Purpose: This study aims to investigate the prevalence of hypertension and explore the barriers to effective management among adult refugees residing in Hagadera Refugee Camp, Kenya.

Methodology: A descriptive cross-sectional study using a mixed-methods approach was employed in Hagadera Refugee Camp (N = 39,264) to assess hypertension prevalence and barriers to its management. The quantitative phase included a survey of 422 randomly selected participants, with data collected through semi-structured questionnaires based on the WHO STEPS tool. Qualitative data were obtained through semi-structured interviews (Key Informant Interviews [KIIs]) and Focus Group Discussions (FGDs) to gather in-depth insights on healthcare access, barriers to treatment, and patient experiences. The mixed-methods approach employed concurrent triangulation, where both data types were analyzed separately and then compared for triangulation. Quantitative data were analyzed using SPSS version 25, while qualitative data were transcribed and analyzed thematically using NVivo 10.

Findings: The study found that the overall prevalence of hypertension among the sample population was 6.8%. Hypertension was more prevalent among males (4.8%) compared to females (1.9%) (Chi=12.27, p-value<0.01), and more common in individuals aged 55 years and above (3.2%) compared to younger age groups (Chi=32.56, P-value<0.00). The highest prevalence was observed among the unemployed (4.3%) and those with no formal education (4.6%). Key barriers identified included limited healthcare resources (medications and diagnostic tools), healthcare staff shortages, poor infrastructure (e.g., long distances to clinics), and low health literacy. Additionally, repatriation and population mobility were significant barriers to continuity of care. Ethical considerations were carefully followed, ensuring informed consent from all participants and maintaining participant confidentiality.

Unique Contribution to Theory, Policy and Practice: This study contributes to the understanding of NCD management in protracted humanitarian settings by demonstrating that traditional emergency-focused health models are insufficient for chronic conditions like hypertension, which require sustained, integrated chronic care. It highlights the “double burden of disease” in refugee camps and the specific challenges posed by encampment policies and parallel health structures.