One of our priority noncommunicable disease (NCD) areas is cardiovascular disease, a broad classification of diseases that affect the heart and surrounding blood vessels. Our programs focus on increasing access to screening, detection and treatment for those most at risk for development of hypertension. Increased awareness of risk, access to affordable drugs, as well as effective lifestyle interventions are key to prevention and control of hypertension worldwide.
Hypertension, or high blood pressure, increases the risk of heart attacks, strokes and kidney failure. Uncontrolled hypertension can have permanent and debilitating health consequences, including blindness, heart attack and heart failure.
Normal levels of both systolic and diastolic blood pressure are essential for efficient function of the heart, brain and kidneys. Clinically, hypertension is defined as a systolic blood pressure equal to or above 140 mm Hg and/or diastolic blood pressure equal to or above 90 mm Hg.
The World Health Organization has shown that directly addressing several key risk factors – tobacco use, harmful alcohol use, unhealthy diet, and physical inactivity – is the most impactful, cost-effective and feasible approach to curbing the rising incidence of NCDs in low- and middle- income countries. Treatment of hypertension usually begins with moderate dietary sodium restriction, weight reduction, avoidance of excess alcohol intake, and regular aerobic exercise. Some individuals may require medications when lifestyle changes alone are not enough to manage the disease.
Effective prevention and control of hypertension will require commitment from governments and policymakers. In addition, health providers, academic researchers, civil society partners, the private sector, families and individuals each have a role to play.
Our network members are working with these stakeholders to determine which prevention and treatment models will be most effective to maximize health impact in the communities we serve.
Making a Difference
Project UDAY focuses on behavior change communication and awareness activities, health provider training and interventions to ensure people maintain their treatment regimens. PSI/India’s specific role is to lead on the development and dissemination of the campaign’s communications materials, community mobilization and training for roughly 300 participating pharmacists on control and treatment of the disease. The PSI/India team is also conducting a population-based study of roughly 13,000 adult men and women to capture their understanding of the illness and its risk factors, and to estimate out-of-pocket expenses at the household level. Evidence from this study will help guide program priorities and resources for maximum impact. Throughout the course of the project, ten hospitals will establish hospital-based diabetes registries to evaluate and improve quality of care among both patients and providers.
Know Your Number Campaign: Improving Hypertension Awareness and Management in Vietnam
Like many countries in Southeast Asia, Vietnam is undergoing a rapid epidemiological transition from infectious diseases to non-communicable diseases. In just 30 years (1990-2010), NCDs increased from 42% to 66% of the total burden of disease in Vietnam.
In 2012, PSI/Vietnam received PSI Innovation funding to use social franchising to improve hypertension awareness, diagnosis and management. The project’s goal is to increase early screening, diagnosis and treatment of hypertension among low-income adults, particularly men, ≥ 40 years of age.
As of 2017, this program has screened over 55,000 adults through its extensive network of over 100 Good Health, Great Life social franchise providers across Dong Nai and Ho Chi Minh City provinces. Provider tools offer guidance and step-by-step instructions on hypertension management and pharmaceutical options. Monthly on-site monitoring and supportive supervision visits with providers ensure high quality implementation of the program employing international best practices.
A key success of the project is the Know Your Number communications campaign which leverages Vietnam’s strong cultural belief in the power of lucky numbers and their tangible impact on livelihood.
The campaign includes:
- Billboard installations, which highlight other common sources of lucky numbers and connect them to blood pressure readings.
- Interpersonal communication outreach in residential and commercial areas with high concentrations of low-income men over 40 years old.
- Market booths with hypertension information, blood pressure screenings and provider referrals.
In Kenya, an estimated 28% of adult men are hypertensive, yet health outreach activities and healthcare facilities predominantly target and reach women. Understanding contextual dynamics like this could be the key to devising and ensuring the success of new solutions. Healthy Heart Africa (HHA), a program launched by AstraZeneca in Kenya in 2014, aims to reach 10 million hypertensive patients in Africa over the next decade.
PSI is proud to be an HHA partner in Ethiopia, where we work in collaboration with the Federal Ministry of Health to build capacity of public sector providers to screen, diagnose and manage hypertension.
- Building Private Provider Networks to Bring Quality Health Services Closer to Underserved Communities
In Vietnam, the private sector can be utilized to advance health care and services for lower income communities. PSI is using its provider network, including the private sector providers, to bring services to underserved areas.
- Non-Communicable Disease Life Course Pocket Cards
At the 61st session of the UN"s Commission on the Status of Women, PSI and its partners on the Women and NCDs Task Force promoted a set of pocket cards illustrating a woman's risk for non-communicable diseases over the course of her lifetime.
- National White Paper: Synergizing Efforts in Diabetes Care at the Tertiary Level
Every year, roughly 5.8 million Indians die from heart and lung diseases, stroke, cancer and diabetes. In other words, 1 in 4 Indians risks dying from an non-communicable disease (NCD) before they reach the age of 70. In line with WHO’s Global action plan for the prevention and control of NCDs 2013-2020, India is the first country to develop specific national targets and indicators aimed at reducing the number of global premature deaths from NCDs by 25% by 2025.
- Promoting Awareness Around Diabetes and Hypertension in India
Two posters that make part of a communications campaign in India, which aims to increase awareness of diabetes and hypertension among adults.