Date of Award

12-2025

Degree Type

Thesis

Degree Name

Master of Science in Advanced Practice Nurs​ing (MSc-APN)​

First Advisor

Dr Rose Maina

Second Advisor

Dr Maureen Akolo

Department

School of Nursing and Midwifery, East Africa

Abstract

Background: Cardiovascular diseases (CVDs) are a rising public health issue in low- and middle-income countries, including Kenya, where there is an escalation of their deaths and preventable risk factors. Community health promoters (CHPs) have a crucial role in the prevention of CVDs. Yet, low knowledge of CVD prevention and low detection of CVD risk factors characterise most underserved communities in Kenya. Little has been documented about CHPs' experiences in mitigating CVDs despite the presence of multilevel barriers and facilitators that can shape their experiences.

Aim: To gain an in-depth insight into the experiences of CHPs in mitigating CVD in Lari subcounty, Kiambu.

Methods: A qualitative descriptive study design was employed, using a purposive sample of 15 CHPs and six key informants. Audio-recorded information was obtained using a semi-structured interview guide. The data were transcribed for an inductive approach qualitative content analysis, using Graneheim and Lundman's (2004) stages, guided by a socio-ecological framework. Data were presented in thematic form and as quotations from participants. The study obtained ethical approval, and informed consent was secured from participants.

Findings: Four themes emerged at the individual, relationship, community, and societal levels. CHPs were aware of their role in CVD prevention, with a low understanding of CVDs due to inadequate training. They faced limited financial support and role conflict despite their commitment. Community acceptance, leadership support and the use of a combination of approaches enhanced engagement, whereas poverty and resistance, rooted in low knowledge, cultural, and religious beliefs, hindered uptake. Despite supervision and teamwork within the health system, staffing gaps and shortages of medication persist. Role recognition, collaboration, and referral structures legitimised CHP efforts, although inadequate resources undermined its sustainability.

Conclusion: In Lari, CHPs faced significant barriers to implementing CVD interventions, including limited resources, insufficient training, and low community awareness. Strengthening their role requires multilevel interventions, including structured training, resource support, and leveraging community trust, which can enhance the sustainability of CVD prevention efforts.

First Page

1

Last Page

178

Download

Share

COinS