More than half (56 per cent) of Kenyans have never had their blood pressure taken, yet nearly one in four adults in Kenya have raised blood pressure (Kenya STEPwise Survey for NCDs Risk Factors 2015 Report - 2015).
Hypertension is the occurrence of persistent raised blood pressure and it is the biggest risk factor for cardiovascular diseases (CVD), the leading cause of death worldwide.
CHAK is implementing two hypertension projects to address and contribute to reduction of the burden of Hypertension in Kenya, the Healthy Heart Africa project and the Norvatis Access project.
This is a three-year project ending in 2020, supported by AstraZeneca. It is implemented in 53 CHAK member health units and seven high volume county health facilities spread across 22 counties.
The project’s strategies involve the key areas of patient awareness, improved care and treatment and control of hypertension. In 2017, patient awareness and education activities were scaled up.
The project began following a realization that it would take long for patients to actively manage their condition on their own because hypertension is asymptomatic. For many Kenyans with hypertension, its management may not be a top priority.
Improving patient linkage to treatment after screening was critical. In 2017 the project targeted usage of out or in-reach screening at clinics, workplaces and communities to improve linkage.
Regular clinic attendance improves blood pressure control. With an estimated 20 per cent of Kenyan adults over the age of 18 having high blood pressure, the HHA programme aims at driving higher attendance to clinics.
The project actively worked to build capacity of health facilities by training and task shifting to support the appropriate use of nurses to manage HTN in order to improve patient treatment experiences and hence improve treatment success.
Education and awareness
Raising awareness on hypertension and its associated risk factors was an effective intervention for communities to change their health seeking behavior and take up regular blood pressure screening.
In 2017, CHAK provided hypertension health education to over 500,000 persons through religious leaders, community health volunteers and health care workers from implementing CHAK MHUs.
The messages were passed by distributing over 10,000 information education and communication (IEC) materials and also through mass media.
In 2017, the HHA project screened a total of 523, 066 persons for high blood pressure in different settings including churches, open air markets, chiefs barazas, work places and health care facilities.
In communities, screening was done by CHVs, who had been trained and equipped with blood pressure machines by the project since 2015 and HCWs in health facilities.
Out of those screened, a total of 98,461 were referred with high blood pressure and subsequently, 26,883 were diagnosed with hypertension.
CHAK has continued to build the capacity of community health systems and health facilities in screening for early diagnosis and to link those diagnosed with hypertension to health facilities for treatment.
In 2017, a total of 301 CHVs received refresher training to improve their skills. The training enabled them to better give health education messages and screen for hypertension. The project also trained a total of 576 HCWs from CHAK MHUs on comprehensive hypertension management. A total of 89 health care providers were trained centrally and 487 through onsite mentorship.
Supply of medicines
Through the HHA and Novartis Access Projects hypertension drug prices have been discounted by over 90 per cent of their commercial value, to a price of Ksh180 – Ksh250 (USD 1.8-2.50) for a month’s dose. The drugs are available from MEDS. Health facilities implementing the two projects are encouraged to procure hypertension drugs from MEDS to ensure accessibility and affordability for patients,
Efficient supply logistics have seen deliveries done to any part of Kenya within 7-10 days of ordering from MEDS.
In 2017, CHAK in collaboration with the Ministry of Health-Non Communicable Diseases Control Unit and other stakeholders, contributed immensely to the development and validation of both the Kenya National Diabetes and Hypertension Curriculums and monitoring and evaluation tools.