Evaluation of Chronic Disease Management Protocols in Primary Healthcare Facilities in Kwara State

Background: Effective chronic disease management at primary care level is essential to reducing the burden of non-communicable diseases in Nigeria. This study evaluates the implementation of chronic disease management protocols across selected primary healthcare centres in Kwara State, North Central geopolitical zone, with a focus on hypertension and diabetes care. Methods: A mixed-methods study combining facility audit and semi-structured interviews with healthcare workers was conducted. Seventeen primary healthcare facilities were audited using a validated quality assessment checklist. Twelve in-depth interviews were conducted with facility-in-charge officers. Results: Protocol adherence was inconsistent across audited facilities. Availability of essential medicines for hypertension and diabetes was intermittent. Documentation practices were poor, limiting continuity of care. Staff reported inadequate training in chronic disease guideline application. Qualitative findings highlighted funding gaps and supervisory deficits as systemic barriers. Conclusion: Structural and human resource weaknesses significantly undermine chronic disease management at primary care facilities in Kwara State. Family medicine professionals should lead protocol standardisation efforts and advocate for sustained funding of essential medicine supply chains within the state's primary healthcare development framework. Keywords: chronic disease management, primary healthcare, Kwara State, non-communicable diseases, protocol adherence