{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T20:35:58Z","timestamp":1791837358025,"version":"4.3.4"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rising cardiovascular morbidity and mortality in rural sub\u2010Saharan Africa are largely attributable to insufficient awareness, treatment and control of hypertension. The delivery of care is further constrained by health system limitations, including shortages of physicians, inadequate infrastructure, challenges in medication supply chains and geographical barriers to access. As a tactic to increase access, adherence and continuity of care, task\u2010shifting hypertension management to nurses\u2014often with the assistance of community health workers\u2014has become popular. The evidence on the efficacy and implementation difficulties of nurse\u2010led hypertension therapies in rural Sub\u2010Saharan African settings is compiled in this narrative review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To investigate task\u2010shifted and nurse\u2010led hypertension care in rural SSA, a narrative evaluation was carried out. Terms associated with task\u2010shifting, nurse\u2010led care, hypertension and rural SSA were used to search PubMed, Scopus, Web of Science and Embase. Studies that met the eligibility requirements reported implementation results or patient outcomes. The effectiveness of the intervention, implementation difficulties and enabling variables were highlighted in the narrative synthesis of the data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In rural Sub\u2010Saharan Africa, nurse\u2010led and task\u2010shifted treatments enhanced medication adherence, blood pressure control and continuity of care. Protocol\u2010driven nurse management, patient education, follow\u2010up monitoring and assistance from mobile health tools or community health professionals were common elements. Drug stockouts, scope\u2010of\u2010practice limitations, inadequate training, supervision and partial integration into primary care were among the implementation obstacles. Alignment with current health systems, community involvement and structured mentoring were among the facilitators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Evidence from rural Sub\u2010Saharan Africa indicates that task\u2010shifting hypertension care to nurses is feasible and, when adequately supported, can improve key care processes and outcomes. To optimize the potential benefit of nurse\u2010led hypertension management in rural settings, it is imperative to address health system bottlenecks, improve training and supervision and align regulatory frameworks with task\u2010shifting strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tmi.70155","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T04:16:45Z","timestamp":1777349805000},"page":"953-965","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Task\u2010Shifting to Nurses for Hypertension Control in Rural Sub\u2010Saharan Africa: A Narrative Review of Effectiveness and Implementation Challenges"],"prefix":"10.1111","volume":"31","author":[{"given":"Aime Ishimwe","family":"Mugisha","sequence":"first","affiliation":[{"name":"Faculty of Medicine University of Rwanda  Kigali Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0692-9027","authenticated-orcid":false,"given":"Olivier","family":"Uwishema","sequence":"additional","affiliation":[{"name":"Department of Research and Education Oli Health Magazine Organization  Kigali Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia Daniel","family":"Bisetegn","sequence":"additional","affiliation":[{"name":"Department of Research and Education Oli Health Magazine Organization  Kigali Rwanda"},{"name":"School of Pharmacy, Faculty of Natural Sciences University of the Western Cape  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hubert","family":"Uwisanze","sequence":"additional","affiliation":[{"name":"Rwanda Ministry of Health  Kigali Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boluwatife Samuel","family":"Fatokun","sequence":"additional","affiliation":[{"name":"Department of Research and Education Oli Health Magazine Organization  Kigali Rwanda"},{"name":"Faculty of Basic Medical Sciences Kwara State University  Malete Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0384-4155","authenticated-orcid":false,"given":"Subham","family":"Roy","sequence":"additional","affiliation":[{"name":"Department of Research and Education Oli Health Magazine Organization  Kigali Rwanda"},{"name":"Hull York Medical School University of York  York UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s43058-020-00048-y"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002561"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0103754"},{"key":"e_1_2_12_5_1","doi-asserted-by":"crossref","unstructured":"A. I.Mugisha I.Nzayisenga andF.Munyaneza \u201cPrevalence of Newly Diagnosed Hypertension in Patients Presenting With Stroke at the Medical Emergency Department of Rwanda Military Referral and Teaching Hospital: A Five\u2010Years Retrospective Study (2020\u20132025) \u201d In Review 2025 https:\/\/www.researchsquare.com\/article\/rs\u20107143510\/v1.","DOI":"10.21203\/rs.3.rs-7143510\/v1"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jash.2010.02.002"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-015-0111-8"},{"issue":"1","key":"e_1_2_12_8_1","article-title":"Barriers to Medication Adherence Among Hypertensive Patients in Deprived Rural Areas","volume":"30","author":"Mamaghani E. 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