# The Makonda Study: Preferences for hypertension care among adults in Malawi

> **NIH NIH R21** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2020 · $211,643

## Abstract

Project Summary/Abstract
Despite a high burden of non-communicable diseases (NCDs) in low- and middle-income countries, little is
known about how to deliver patient-centered NCD care in these resource-constrained health systems. One-third
of Malawian adults are hypertensive, and nearly all these cases are untreated. Low rates of care-seeking and
treatment contribute to very high premature mortality due to NCDs.
This project aims to understand patient preferences for receiving hypertension care in Malawi among an “expert”
group of adults receiving treatment for HIV; this subpopulation is uniquely well-informed to comment on
experiences and preferences for chronic disease care. We will conduct (1) a discrete choice experiment, with
HIV+ and HIV- adults who have been prescribed at least one medication for hypertension, to understand care-
seeking decisions and trade-offs in this low-resource context. Additionally, we will conduct (2) interviews with
providers and key informants from the health system to understand the potential implications of implementing
and scaling up a patient-centered approach to NCD care in Malawi.
The project will leverage a long-standing partnership between UCLA and Partners in Hope, a Malawian medical
organization. The team has collaborated previously on research, including about HIV and NCDs in Malawi; these
earlier preliminary findings inform the proposed work. The ultimate objective is to develop an evidence-based,
evaluable intervention for providing NCD care in Malawi.
Patient preference and experience studies, as proposed here, are essential for informing the development and
implementation of new models of NCD care worldwide. Discrete choice experiments are increasingly popular in
health services research, but are used rarely for NCDs. Vulnerable populations face barriers in accessing chronic
disease care in many countries, so this study may provide practice and policy insights that are globally relevant.
It will also provide recommendations of opportunities to leverage other successful health services (i.e., for HIV
care) to address NCDs, which is an area of emerging interest for researchers and policymakers in resource-poor
settings worldwide, including in high-income countries.

## Key facts

- **NIH application ID:** 10071470
- **Project number:** 1R21TW011691-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** Risa M. Hoffman
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $211,643
- **Award type:** 1
- **Project period:** 2020-09-09 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10071470

## Citation

> US National Institutes of Health, RePORTER application 10071470, The Makonda Study: Preferences for hypertension care among adults in Malawi (1R21TW011691-01). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10071470. Licensed CC0.

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