Enhanced Facility-Based Hypertension Screening: A Quality Improvement Initiative at Primary Health Care Facilities in Ethiopia

Less than half of people with hypertension in Ethiopia are diagnosed, and only one-third of adults visiting primary care facilities have their blood pressure (BP) screened. We implemented a quality improvement (QI) initiative across six facilities in Ethiopia to increase facility-based BP screening. Process mapping identified barriers, and interventions were tested in iterative QI cycles: establishing BP screening desks at key service points, ensuring the availability of validated BP devices, training staff in accurate measurement, standardizing documentation, and reviewing screening indicators in performance meetings. Between April 2024 and February 2025, monthly BP screening of adults without a hypertension diagnosis increased from 41.0% of 13,707 eligible adults to 79.6% of 14,270 eligible adults. Monthly hypertension program enrollments rose from 40 in April 2024 to 125 in February 2025. Strengthening primary health care systems to systematically measure BP for all adults visiting health facilities can significantly improve hypertension detection and treatment.