Evaluation of the Hypertension Surveillance System at Pilot Hypertension Prevention and Control Health Facilities in Addis Ababa, Ethiopia, 2022

Introduction Hypertension is a major cause of premature death worldwide. Evaluating a surveillance system promotes the best use of data collection resources and ensures that systems operate effectively. It allows us to determine whether a specific system is useful for a particular public health initiative and is achieving the goals of the public health program and the data collection objectives. Ethiopian hypertension control initiatives were recently launched (2019) and implemented in limited health facilities. Therefore, this evaluation is aimed at the hypertension surveillance system of Addis Ababa, Ethiopia.

A descriptive cross-sectional study was conducted from December 21 to 31, 2022. Eight health care facilities were evaluated based on updated CDC guidelines for evaluating public health surveillance systems, and one key informant from each facility was interviewed using semi structured questionnaire. The data were analyzed descriptively. The data were analyzed with Excel 2021 and summarized by the frequency mean, percentage and rate.

The system detected cases (8/8) and monitored the control rate, attendance rate and missed visits. All interviewed staff (8/8) stated that the case definition, diagnosis and treatment algorism of hypertension were easy. Regarding acceptability, all staff believed that stakeholders were engaged, and 7/8 of the facilities recorded and reported data in a timely manner, but there was no acknowledgment given to the staff (0/8). The stability and data quality were 95% and 72.9, respectively. The representativeness was 24% to 36% based on prevalence, and regarding sex, it ranged from 88% to 108%. predictive positive value (31.4%) and zero flexibility.

The system was useful for detecting morbidities and retaining patients on treatment. It has good simplicity, acceptability and stability but requires improvement in its flexibility, representativeness, data quality and positive predictive value. The system is better able to scale up to other health facilities. Competing Interest Statement The authors have declared no competing interest. Funding Statement This study did not receive any funding. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study was approved by the institutional review board of Ethiopian Public Health Institute (EPHI). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All data produced in the present work are contained in the manuscript.