Abstract
BACKGROUND: Strengthening primary healthcare (PHC) worker’s clinical capacity remains critical for improving non-communicable disease (NCD) outcomes in low-resource settings. This study evaluated a targeted training for PHC workers in Kisumu County, Kenya, focusing on diabetes and hypertension management. The aim of the study was to evaluate a training intervention by assessing its relevance, acceptability, and feasibility, as well as its initial effects on both knowledge and clinical care practices in diabetes and hypertension management. METHODS: A mixed-methods design was used, involving 24 purposively selected PHC workers from 10 PHC facilities. Quantitative data were collected at three time points: pre-training, post-training, and three months later using structured questionnaires and observation checklists to assess changes in NCD knowledge and clinical care practices. Qualitative data from focus group discussions explored perceptions of PHC workers, barriers, and facilitators to implementation. Statistical analyses included paired-t-tests, McNemar’s test, and Wilcoxon signed-rank test while qualitative data were analyzed thematically using Dedoose software. RESULTS: The training intervention received high acceptability ratings, with a mean score of 4.80 out of 5. NCD knowledge significantly improved post-training (mean score: 6.46 to 8.17, p = 0.0002), a 26% increase and was largely retained at the three-month follow-up. Clinical care practices also improved initially (mean score: 3.17 to 4.29, p = 0.0032), but declined at follow-up (mean score: 3.71, p = 0.0284), reflecting challenges in sustaining behavior change. Observational data and qualitative findings revealed systemic barriers such as inadequate resources and weak technical support that hindered consistent application of the learned practices. CONCLUSIONS: While the training intervention effectively improved PHC workers’ knowledge on DM and HTN management and short-term clinical practices, sustained improvements in care delivery require complementary systemic interventions. These include strengthening facility readiness, supply chains, and ongoing mentorship to support the translation of knowledge into routine clinical practice. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-026-14375-8.