Start Submission Become a Reviewer

Reading: Healthy Heart Africa—Kenya: A 12-Month Prospective Evaluation of Program Impact on Health Ca...

Download

A- A+
Alt. Display

Original Research

Healthy Heart Africa—Kenya: A 12-Month Prospective Evaluation of Program Impact on Health Care Providers’ Knowledge and Treatment of Hypertension

Authors:

Elijah N. Ogola ,

Department of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, KE
X close

Francis O. Okello,

Division of International Development, Abt Associates, Bethesda, MD, US
X close

Jane L. Herr,

Division of International Development, Abt Associates, Bethesda, MD, US
X close

Elizabeth Macgregor-Skinner,

Division of International Development, Abt Associates, Bethesda, MD, US
X close

Ashling Mulvaney,

Global Sustainability, AstraZeneca, Cambridge, GB
X close

Gerald Yonga

Department of Medicine, Aga Khan University, Nairobi, KE
X close

Abstract

Background: Given the rising burden of hypertension in Africa, the Healthy Heart Africa program was developed to improve access to quality hypertension care in the primary care setting. The Healthy Heart Africa program provides a comprehensive, coordinated intervention directed at health care providers (HCPs) and the general public.

Objective: The impact of Healthy Heart Africa on HCPs’ knowledge of hypertension and facility-level services in Kenya was evaluated by a 12-month prospective study.

Methods: Intervention facilities were selected by stratified random sampling and matched to similar control facilities. Intervention facilities received a hypertension treatment protocol, equipment, training and patient education materials, and improved medical supply chain, whereas control facilities did not. HCPs responsible for hypertension care were surveyed at baseline and 12 months later. Hypertension screening and treatment data were abstracted from service delivery registers. A differences-in-differences analysis estimated the impact of Healthy Heart Africa on HCPs’ knowledge, hypertension services, and the number of patients diagnosed with and seeking treatment for hypertension.

Results: Sixty-six intervention and 66 control facilities were surveyed. Healthy Heart Africa improved HCPs’ knowledge of ≥5 hypertension risk factors and ≥5 methods for reducing/managing hypertension but not hypertension consequences. At end line, more intervention than control facilities measured blood pressure more than once during the same visit to diagnose hypertension, dedicated days to hypertension care, used posters to increase hypertension awareness, and provided access to hypertension medications. The number of patients diagnosed with hypertension and those seeking treatment for hypertension increased with intervention, but the change was not significant relative to control subjects.

Conclusions: HCP-directed hypertension education and provision of basic resources positively influenced hypertension care in Kenya in the first 12 months of implementation.

Highlights

  • The increasing prevalence of HTN in Africa is a growing concern.
  • HHA is an HTN intervention directed at providers and the public.
  • HHA aims to raise HTN awareness and care through public-private collaboration.
  • HHA had a positive effect on providers’ knowledge of HTN.
  • Provider-directed education and access to basic services may improve HTN care.
How to Cite: Ogola EN, Okello FO, Herr JL, Macgregor-Skinner E, Mulvaney A, Yonga G. Healthy Heart Africa—Kenya: A 12-Month Prospective Evaluation of Program Impact on Health Care Providers’ Knowledge and Treatment of Hypertension. Global Heart. 2019;14(1):61–70. DOI: http://doi.org/10.1016/j.gheart.2019.02.002
30
Views
22
Downloads
Published on 01 Mar 2019.
Peer Reviewed

Downloads

  • PDF (EN)

    comments powered by Disqus