Healthy Heart Africa: Creating the Evidence Base for CVD
Primary Care March 2, 2015 Global Health Mini-University
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2 AstraZeneca: Who Are We? 50.000 employees in 100 countries
Supply & Manufacturing in 16 countries R&D capabilities
across 3 continents A 100-year heritage in cardiovascular
disease
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Why are we here today? Kioko has high blood pressure but is
completely unaware Has a wife and two children and lives outside
Nairobi Earns approx. $300 per month, and has few savings Doesnt
believe in exercise he thinks its for the very rich or poor and
admits that hes slightly overweight. Eats two big meals a day,
smokes and drinks beer socially Doesnt engage with healthcare
system very often and has never been told about hypertension Meet
Kioko 3
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Cardiovascular Disease in Africa Around 40% of adult Kenyans
have raised blood pressure Source: World Health Organization
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Tackling the challenges of hypertension Healthy Heart Africa 5
Healthy Heart Africa is an innovative and sustainable programme
that aims to improve the lives of hypertensive patients across
Africa The first initiative of this scale will lay the foundation
for future programmes focused on preventing and treating NCDs In
line with the World Health Organisation (WHO)s 25 by 2025 framework
for preventing and controlling NCDs The ambition of Healthy Heart
Africa is to reach 10 million hypertensive patients across Africa
by 2025.
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Healthy Heart Africa A partnership approach 6
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Healthy Heart Africa A holistic approach to healthcare delivery
7 Barriers Education & AwarenessProvider training &
GuidelinesAccess & Affordability Solutions Mobilise patients to
seek screening and treatment Promote routine screening and timely
diagnosis Improve access and adherence to treatment Outcomes
1.Increased awareness of risks of hypertension 2.Increased
motivation to be diagnosed and seek the right treatment 3.Increased
access to appropriate and affordable medicine
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Healthy Heart Africa A real and lasting impact 8
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9 Thanks!
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March 2, 2015 Conquering Hypertension in Kenya- Healthy Heart
Africa Program Mychelle Farmer, MD Jhpiego Senior NCDs Advisor
March 2015
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Healthy Heart Africa Program The program is based upon three
pillars Training and Guidelines Education and Awareness Access and
Affordability Uses existing health platforms within Jhpiego-
supported health programs, integrating hypertension prevention and
control 11
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Target Districts in Kenya 12
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Healthy Heart Africa: Training A key element for successful
integration of hypertension screening into quality health care
Jhpiego leads training, in collaboration with MoH, AstraZeneca,
Kenyan Cardiology Society 13
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Healthy Heart Africa: Training Competency-based approach, using
ToT as trainers and clinical mentors at facility level Train 104
service providers Orient 330 CHVs in hypertension awareness,
screening and referral 14 CHV= Community Health Volunteer
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Program Scale-Up Strategy Targeting 16 priority health
facilities for Phase One Training to expand to 100 additional
clinics in Phase Two Evaluate information dissemination 15
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Scale-Up Community Awareness Key approach to increase HTN
screening CHVs to conduct community awareness campaigns SMS
messages, IEC materials available Community-based, family- centered
16 500,000 adults to be screened for hypertension in target
districts
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Conclusions Screening to reduce complications of HTN Increase
awareness of HTN, CVD Significantly increase access to quality care
Scalable, sustainable NCDs programming 17 Target: 80% of diagnosed
patients continue on treatment
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Thank you! 18 Mychelle Farmer- [email protected]
Jhpiego Kenya Team: Nancy Koskei Moses Kitheka Linda Archer Anthony
Gichangi Manya Dotson James Riungu Isaac Malonza
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KRISTIN SAUCIER New Business Development PS KENYA: Harnessing
the Power of the Private Sector for HHA
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PAGE 21 Global Impact of NCDs
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Tunzas scale and efficiency allows us to reach more people with
quality assured products and services.
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PS Kenyas Role in HHA page 25 Leveraging existing services
offered by Tunza clinics, PS Kenya is contributing to HHAs goals
through:
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Program Launch: Official launch of HHA alongside program
partners and in partnership with the Kenyan Ministry of Health in
Nov 2014 Provider Recruitment: Mapping of facilities and engagement
with providers to gauge willingness to participate 64 Tunza social
franchise clinics and 20 private pharmacies recruited by Dec 2014
Additional facilities to be added in early 2015 Key Staff
Recruitment: Recruitment of M&E coordinator, demand generation
coordinator, and health services coordinator Key Milestones to
Date
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Training: PS Kenya led a workshop to develop and test the
initial creative concepts for awareness and education materials
Jhpiego-led training for 86 private providers and pharmacists on
diagnosis and management of HTN Supply Chain Management: Securing
initial contracts with distributors across supply chain Progress to
Date Contd. page 27
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Cross-sector collaboration is crucial. There is a need to
engage closely and early with MOH, especially for new health area
programming Early staff recruitment and buy-in is vital to support
initial program start-up Initial program design must be adaptable
and flexible to local demands and realities of the providers and
consumers. Lessons to Date page 28
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Thank you! page 29
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30 Healthy Heart Africa Evaluation Elizabeth Macgregor-Skinner
Global Mini-University March 2, 2015
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Lack of documentation for HTN/CVD programming Opportunity to
inform Kenyan stakeholders of what works as Kenya implements its
NCD strategy Share evidence for effective clinical and community
interventions for hypertension in Kenya and internationally
Understand why programs were effective Inform scale up, replication
and continuous learning Rationale
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The HHA Monitoring and Evaluation Strategy Enabling long term
sustainability by providing credible and independent data to
support advocacy and partnership strategy Providing independent
data to test whether our strategy is working and inform how to
continue to implement and expand across Kenya & Africa
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Baseline surveys - Facilities - Households Monitoring -
Facilities - Community activities Endline surveys - Facilities -
Households In-depth interviews Baseline report- April 2015 -
Monitoring dashboard - Quarterly reports Impact and process
evaluation August 2016 Overview of M&E Project implementation
Data collection M&E outputs Project timeline
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Baseline Report Data to guide implementation, including
Demographics and lifestyle of target population Awareness and
attitudes Treatment for hypertension Barriers to receiving
hypertension care Health facility staff knowledge, attitudes, and
practice around hypertension care Equipment, medications, and
information materials on hypertension at health facilities
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On-going Monitoring Health care workers trained Adults
screened, referred, and treated Prevalence of (pre)hypertension
among those screened % of patients entering treatment who attend
follow-up appointments % of patients lost to follow-up at each
stage Monthly data to guide implementation and track progress:
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Endline: Impact Evaluation Estimates of the impact of HHA on:
Awareness and knowledge % of adults screened for hypertension % of
adults treated for hypertension Provider knowledge, attitudes, and
practice around hypertension care
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Endline: Process Evaluation Assessment of HHA implementation
including: At an operational level what aspects of the program
worked well? what aspects didnt work as intended or faced
significant challenges? What contextual factors presented
challenges/facilitated the success? What are the concerns of
stakeholders for scale-up?
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Stakeholder Dissemination Kenya National government County
governments Implementing partners Evaluation partner Kenyan NCD
Alliance Key opinion leaders General public Private Sector Local
private sector Professional Associations Other private sector
interested in NCDs Other African Governments and Regional Bodies
African National Governments African Development Bank PASCAR EAC
International Organizations and Donors USAID DFID NORAD EU
Department of Health and Human Services/CDC World Bank Swedish SIDA
Potential Partners and Influencers NGOs and Civil Society Council
on Foreign Relations NCD Roundtable Corporate Council on Africa
Academia
