Table 1 Twelve clusters with corresponding statements

1. Provision of primary health care

1. Their closeness to the facility is considered too.

20. Availability of drugs at an affordable price for patient consumption.

33. Restructuring the PHC setting in such a way that the nurse is officially allowed to see the sick when the doctor is not around or very busy especially at the outpatient clinic and emergency clinic.

75. Making ART clinic a one-stop clinic for PLHIV/hypertension to reduce waiting time.

77. Prompt linkage of hypertensive clients to physician and other relevant facilities for further management.

2. Adequate provision of drugs

11. Financial support.

12. Provision of primary health care.

38. Working environment should be more conducive for the health worker clients.

53. Conducive work environment.

60. Provision of subsidized anti-hypertensive drugs.

65. Drugs for management of hypertension should be available in the HIV clinic.

3. Monitoring their BP

5. Ensure regular monitoring of BP at every clinic visit.

18. Monitor vital sign regularly.

27. Proper clinic standard operating procedure (SOP).

48. Proper follow-up strategies on clients.

51. Monitor intake and output chart.

52. Great nurse/patients relationship

57. Monitoring of blood pressure.

70. Proper supervision of standard operating procedure (SOP).

4. Human resources

2. Employ more nurses.

14. Availability of human resources.

43. The PHC organogram should be revisited to put the nurse in their proper position.

45. Human resources—more nurses.

46. More nurses to be employed into the PHC setting.

68. Relegation of power—let people take responsibility.

72. Adequate man power.

5. Teamwork/proper referrals

4. Ensuring that each clinic, i.e., both HIV and medical outpatient clinic (hypertension) falls on the same visit.

8. Supervision of staff on providing care.

15. Aligning both clinic appointments to fall on the same day.

69. Providing measures in improving their health care, i.e., the clinic should be interwoven (the appointment should always be the same date) to avoid excessive stress.

80. Effective teamwork.

6. Incentives for the nurses

13. Encouragement of work delegation.

32. Consideration of the number of nurses in a clinic

40. There should be clarity on which task is shifting to who, to avoid unnecessary rivalry among health workers

54. Incentive for the nurses.

7. Equipment

16. More working tools like protective measure—gloves, apron, boots, cap and face mask, and testing kits.

21. Provision of blood pressure apparatus.

24. Blood pressure monitoring manual.

31. Provision of functioning sphygmomanometer at the clinic always.

36. Adequate provision of materials/equipment.

39. Government should be ready to supply and provide everything needed for

41. We need materials or instrument to manage the HIV/hypertension patient.

49. Provision of HIV test kit and drugs.

50. Provision of facilities needed.

56. Available equipment to work with.

58. Weighting scales (SECA) with height.

64. Enhance current medical equipment

73. Regular supply of working tools and necessary materials.

81. Provision of better equipment to work with.

8. Ensuring proper patient counseling/education

3. Counseling of patient for follow-up.

7. Proper follow-up and non-abrupt stoppage of BP drug.

17. Provision of counseling to the patients.

42. Ensuring that each patient has their BP apparatus to monitor their blood.

62. Ensuring daily use of anti-hypertensive drug.

71. Proper health education on diet and lifestyle.

74. Encourage clients to have personal BP apparatus for their home use, in order to identify BP and report before appointment day if necessary.

76. Proper health education on hypertension with people living with HIV during each visit to the clinic.

9. Health education

26. Re-educating patients on importance of diet, rest and adherence in the management of HIV/hypertension.

34. Encouraging patient on the importance of adherence to drug regimen to prevent relapse in healthcare.

44. Stressing the do’s and don’ts of people living with HIV and hypertension, i.e., smoking, drinking of alcohol, and use of protective materials during sexual intercourse.

66. We need to give them quality counseling.

67. Intensified health education on hypertension with people living with HIV on clinic days.

10. Proper training of nurses for administration

6. Training for nurse to improve their knowledge on hypertension.

9. Nurses need better understanding of the case.

19. Proper training of nurses for administration.

28. Training to nurses on how to provide psycho-social support to patients.

30. Training of health workers on the update of HIV drugs.

35. Constant continuous communication in the form of training and re- training for nurses.

78. We need proper training to be able to manage the patients.

11. Training for health workers on [HTN related] HIV

10. Personal training on adherence counseling on lifestyle modification, medication, and diet.

22. We need to know the patient's problems.

25. Training on screening patient with cardiovascular risk.

55. Provide detailed and good understanding of task-shifting strategies for hypertension control.

59. Constant review of training workshop of nurses and more health workers on ground.

63. Adequate knowledge of anti-retrovirals that can affect blood pressure.

79. Knowledge on the treatment of hypertension.

12. Outreach

23. Early detection of people living with hypertension.

29. Sensitization.

37. Prioritizing patient health care according to their health care needs.

47. There should be good advocacy, communication between health workers and the community to know prevention and precaution and how to go about it.

61. Awareness—sensitize the environment.