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Cost-Effectiveness and Implementation Strategies for Hypertension Management Using Non-Physician Healthcare Workers
Gabriel Lamkur Shedul1,2,3, Olutobi Adekunle Sanuade4,5,6, Emmanuel Iroboudu Okpetu1,2
1Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, United States.
Global Heart
|March 16, 2026
Summary
Non-physician healthcare workers effectively manage hypertension in low- and middle-income countries, offering a cost-effective solution. Further research is needed to confirm these findings across diverse settings.
Area of Science:
- Public Health
- Health Economics
- Global Health
Background:
- Hypertension is a major global health challenge, particularly in low- and middle-income countries (LMICs).
- Non-physician healthcare workers (NPHCWs) are increasingly involved in managing chronic diseases in resource-limited settings.
- Assessing the economic viability and implementation of NPHCW-led hypertension management is crucial for healthcare policy.
Purpose of the Study:
- To systematically review the cost-effectiveness of hypertension management by NPHCWs in LMICs.
- To identify effective implementation strategies for NPHCW-led hypertension care programs.
- To synthesize evidence on economic outcomes and cost-effectiveness metrics.
Main Methods:
- Systematic literature search (inception-May 2024) adhering to PRISMA guidelines.
- Inclusion of economic evaluations of adult hypertension management by NPHCWs in LMICs.
- Assessment of study quality using Drummond's checklist and ROBINS-I.
Main Results:
- Seven studies (2002-2022) from eight countries were included, utilizing diverse study designs.
- NPHCWs involved included pharmacists, community health workers, and nurses.
- Cost-effectiveness outcomes varied, with measures like cost per mmHg reduction, cost per DALY averted, and cost per QALY gained indicating potential value.
Conclusions:
- Hypertension management by NPHCWs demonstrates cost-effectiveness in LMICs.
- Implementation strategies often involve training NPHCWs and community engagement.
- Additional research is recommended to enhance the generalizability of findings across diverse LMIC contexts.
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