Effect of Task-Shifting on Quality of Hypertension Care at Primary Healthcare Centres in Oyo State

Background: Task-shifting to non-physician healthcare workers offers a strategy for extending hypertension management to underserved populations in Nigeria, but its effect on care quality requires rigorous evaluation. This study examines the effect of task-shifting on quality of hypertension care at primary healthcare centres in Oyo State, South West geopolitical zone. Methods: A mixed-methods study compared hypertension care quality metrics between primary health centres with task-shifted nurse-led care and those providing physician-led care. Clinical record audits of 400 patient records and structured interviews with 30 healthcare workers provided quantitative and qualitative data. Results: Blood pressure control rates were equivalent between task-shifted nurse-led and physician-led models when standardised protocols were followed. Medication adherence support and health education delivery were rated higher in nurse-led models. Protocol fidelity was the strongest predictor of care quality in both arms. Qualitative findings highlighted training quality and supervisory support as key enablers. Conclusion: Task-shifting is a viable quality-preserving strategy for hypertension management in Oyo State primary care settings when implemented with structured protocols and adequate supervision. Family medicine departments should lead the development of nurse competency frameworks for chronic disease management. Keywords: task-shifting, hypertension, primary healthcare, care quality, Oyo State