Knowledge and understanding of cardiovascular disease risk factors in Sierra Leone: a qualitative study of patients’ and community leaders’ perceptions

Agnieszka Ignatowicz, Maria Lisa Odland, Tahir Bockarie, Haja Wurie, Rashid Ansumana, Ann H. Kelly, Chris Willott, Miles D Witham, Justine Davies

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Objectives: Prevalence of cardiovascular disease risk factors (CVDRF) is increasing, especially in low-income countries. In Sierra Leone, there are no previous studies on the knowledge and the awareness of these conditions in the community. This study aimed to explore the knowledge and understanding of CVDRF, as well as the perceptions of the barriers and facilitators to accessing care for these conditions, amongst patients and community leaders in Sierra Leone.

Design: Qualitative study employing semi-structured interviews and focus group discussions.

Setting: Urban and rural Bo District, Sierra Leone.

Participants: Interviews with a purposive sample of 37 patients and two focus groups with six to nine community leaders.

Results: While participants possessed general knowledge of their conditions, the level and complexity of this knowledge varied widely. There were clear gaps in knowledge regarding the coexistence of CVDRF and their consequences, as well as the link between behavioural factors and CVDRF. An overarching theme from the data was the need to create an understanding and awareness of CVDRF in the community in order to prevent and improve management of these conditions. Cost was also seen as a major barrier to accessing care for CVDRFs.

Conclusions: The knowledge gaps identified in this study highlight the need to design strategies and interventions that improve knowledge and recognition of CVDRF in the community. Interventions should specifically consider how to develop and enhance awareness about CVDRF and their consequences. They should also consider how patients seek help and where they access it.

Strengths and limitations of this study
•This is one of the first studies exploring patient and community knowledge and understanding of CVDRF in Sierra Leone.
•Interviews and focus group discussions were undertaken by a researcher who is a Sierra Leonean and trained in qualitative research.
•The study focused on people who had sought care for their conditions and only a small number of community leaders. Therefore, the results may not be representative of the entire community.
•The study was done in one district of Sierra Leone.
Original languageEnglish
Article numbere038523
JournalBMJ open
Issue number12
Publication statusPublished - 15 Dec 2020


  • CVD risk factors
  • community leaders
  • focus group discussions
  • interviews
  • knowledge and understanding
  • patients


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