Sarah Andrea Lolo^{1, 2,}, Andrew Katende^{2, 3}, Leila Samson^{1, 4}, Chipegwa Mlula³, Evance Mahundi^{2, 3}, Hassan Matimbwa^{1, 5}, Liliane Pasape⁶, Irene R. Moshi², Martin Rohacek^{2, 7}

Introduction: Information about heart failure and hypertension, and barriers to treatment adherence of patients with cardiovascular diseases living in rural sub-Saharan Africa is scarce. Objective: To explore knowledge about heart failure and hypertension, as well as barriers to treatment adherence and follow-up visits among patients with heart failure and hypertension.Methods: This cross-sectional qualitative study was conducted from July to November 2023 at the Heart and Lung clinic of the St. Francis Regional Referral Hospital Ifakara. Using purposive sampling, 30 in-depth interviews were conducted among patients with heart failure and hypertension. Data were analyzed thematically.Results: Most participants showed limited understanding of risk factors, and of the chronicity of hypertension and heart failure. Salt and fat were commonly reported as the risk factors for hypertension and heart failure. Most participants had a good understanding on how to take their medications daily, and their negative side effects. Challenges were categorized into individual and facility factors. Individual factors included social support, health insurance, financial support, transport costs, distance to healthcare facilities, the chronic condition and severity of illness. Facility factors involved clinic appointments, patient-provider, drug costs, availability, perceived waiting times, and consultation fees. Conclusion: This study found a limited understanding on hypertension and heart failure and about risk factors and the chronicity of these conditions. Tailored interventions are essential to address these challenges.

Non-communicable disease, knowledge, heart failure, hypertension, cardiovascular disease, medication adherence, follow-up visit, challenge