Hypertension self management in rural South Africa is shaped by complex interactions between individual behaviors, social support networks, and healthcare system factors, with gaps between patients' knowledge and implementation of recommended self-management behaviors.
Key Findings
Results
Four major themes emerged from qualitative analysis of hypertensive patients' self-management experiences in rural South Africa.
Themes were identified using Tesch's open coding method of thematic analysis applied to in-depth individual interviews
The four themes were: (1) hypertension self management practices; (2) knowledge and understanding of hypertension management; (3) challenges affecting treatment adherence and blood pressure control; and (4) support systems for self-management
Data were collected through in-depth individual interviews with hypertensive patients at primary healthcare clinics in Ga-Dikgale, Capricorn District, Limpopo Province
A qualitative, exploratory, descriptive, and contextual research design was employed
Results
Gaps existed between patients' knowledge of recommended self-management behaviors and their actual implementation of those behaviors.
Patients demonstrated knowledge of hypertension management but did not consistently translate this into recommended self-management practices
This knowledge-practice gap was identified as a key finding across the study population
The setting was rural primary healthcare clinics in a resource-constrained environment in Limpopo Province, South Africa
Results
Medication adherence among hypertensive patients was inconsistent.
Inconsistent medication adherence was identified as a key finding from the interview data
This was categorized under challenges affecting treatment adherence and blood pressure control
Resource-constrained settings with limited healthcare access and continuity of care were noted as contributing contextual factors
Results
Patients relied on both biomedical and traditional health practices for managing hypertension.
Concurrent use of biomedical treatment and traditional health practices was documented among patients receiving treatment at primary healthcare clinics
This dual reliance was identified as a distinct pattern within the hypertension self-management practices theme
The study was conducted in Ga-Dikgale, a rural community in Limpopo Province, South Africa, where traditional health practices may be culturally embedded
Results
Family support and healthcare system factors were identified as important influences on hypertension self-management.
Support systems for self-management constituted one of the four major themes emerging from the data
Both family support and healthcare system factors were found to influence patients' ability to manage their hypertension
These factors were identified through in-depth individual interviews with hypertensive patients in the study setting
Conclusions
Strengthening patient-centered education, ensuring consistent availability of antihypertensive medication, and enhancing family and community-based support were identified as essential strategies for improving hypertension control in rural primary healthcare settings.
Inconsistent medication availability was implicated as a healthcare system factor affecting blood pressure control
Patient-centered education was recommended to address the gap between knowledge and self-management behavior implementation
Family and community-based support enhancement was identified as a strategy alongside biomedical interventions
Recommendations were framed specifically for rural primary healthcare settings in resource-constrained environments
What This Means
This research suggests that people living with hypertension (high blood pressure) in rural South Africa face a complex set of challenges in managing their condition day to day. Even when patients know what they are supposed to do — such as taking medication regularly, following dietary advice, and exercising — they often struggle to put that knowledge into practice consistently. The study also found that many patients use both conventional medical treatments and traditional remedies at the same time, which reflects the cultural context of the rural communities studied.
The research further suggests that managing hypertension is not just an individual challenge but is deeply influenced by social and healthcare system factors. Family members play an important role in supporting or hindering a patient's self-management efforts, and problems within the healthcare system — such as unreliable availability of blood pressure medications at local clinics — make consistent treatment difficult. These system-level barriers are particularly significant in resource-constrained rural settings where patients may have limited access to healthcare facilities.
This research suggests that improving blood pressure control in communities like Ga-Dikgale requires a multi-pronged approach: better patient education that helps people not just understand hypertension but actually change their behavior, reliable supply of medications at primary healthcare clinics, and stronger involvement of families and communities in supporting patients. The findings highlight that treating hypertension in low-resource rural settings goes well beyond prescribing medication and requires attention to the broader social and systemic environment in which patients live.
Bopape M, Mmusi S, Mothiba T. (2026). Self management strategies for hypertensive patients on treatment in selected clinics at Ga-Dikgale, Capricorn District, Limpopo, South Africa.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1872496