Reimagining Hypertension Care in South Africa

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South Africa may be on the cusp of transforming how hypertension is managed, thanks to innovative research that is bringing healthcare directly into communities.

Researchers, policymakers, healthcare professionals, government leaders, community representatives and traditional leaders recently gathered at the IMPACT-BP Symposium, hosted by the University of KwaZulu-Natal’s (UKZN) College of Health Sciences (CHS) and the Africa Health Research Institute (AHRI), to discuss practical solutions to one of the country’s most pressing public health challenges.

The symposium showcased the findings of the ground-breaking IMPACT-BP Study, led by UKZN’s Professor Nombulelo Magula and AHRI’s Professor Mark Siedner. Conducted in rural KwaZulu-Natal, the study evaluated a home-based, technology-supported model of hypertension care designed to improve long-term blood pressure control while reducing pressure on overstretched healthcare facilities.

Hypertension, often referred to as the ‘silent killer’, affects millions of South Africans and remains a leading contributor to strokes, heart attacks, kidney disease and premature death. Despite the availability of treatment, many patients struggle to maintain consistent blood pressure control due to barriers such as travel costs, long clinic waiting times and limited access to healthcare services.

The IMPACT-BP Study sought to address these challenges by shifting care closer to where people live. Community healthcare workers conducted home visits, monitored blood pressure, supported medication adherence and used digital health tools to improve patient follow-up and engagement. Medication delivery services further reduced the need for frequent clinic visits.

Eighty percent of participants receiving the intervention achieved blood pressure control within six months of the study, compared to just 33% of those receiving standard care. Researchers found that home-based monitoring, digital health technologies and medication delivery significantly improved patient engagement and adherence to treatment.

The findings suggest that the model could prevent thousands of cases of stroke, heart disease and kidney failure while reducing long-term healthcare costs and easing the burden on primary healthcare facilities. Speaking at the symposium, Deputy Minister of Health, Dr Joseph Phaahla, congratulated the research team on their achievements and highlighted the importance of strengthening community-based healthcare systems.

“Hypertension remains a silent killer affecting nearly one-third of Africa’s adult population,” he said. “The success of the IMPACT-BP Study emphasises the need to strengthen community healthcare. We call for stronger collaboration between government, academia, healthcare providers and communities to scale up effective interventions.”

The symposium brought together other influential stakeholders in the health sector, including, Chairperson of Parliament’s Portfolio Committee on Health Dr Faith Muthambi; Member of Parliament’s Portfolio Committee on Health Dr Karl le Roux; Dr Anastase Dzudie from the Pan-African Society of Cardiology; Ms Rebone Ntsie, Chief Director: Nutrition, Oral Health and Health Promotion at the National Department of Health; Ms Penelope Msimango, Head of KZN Health, Ms Sindi Mthethwa, KZN Programme Manager: Chronic Diseases, Geriatrics and Eye Care; Mr Bheki Fakude from the Umkhanyakude District; Chief Operating Officers of Hospitals, representatives from the KwaZulu-Natal Department of Health; researchers; community healthcare workers; civil society organisations; traditional leaders; and study participants.

Professor Busisiwe Ncama, Deputy Vice-Chancellor and Head of the CHS, said: “As South Africa continues to confront a growing burden of non-communicable diseases, the IMPACT-BP Study offers a promising roadmap for the future, one where quality healthcare is more accessible, patient-centred and delivered closer to home. The evidence exists, the partnerships are in place, and the opportunity to transform hypertension care is within reach. Congratulations to the team who have proven that stronger health systems can be built through collaboration, innovation and community-driven approaches.”

Words: MaryAnn Francis

Photographs: Africa Health Research Institute