A multilevel and multicenter assessment of health care system capacity to manage cardiovascular diseases in Africa: a baseline study of the Ghana Heart Initiative

BMC Cardiovascular Disorders

Research

Ron J.G. Peters¹  Juliette Edzeame²  Alfred Doku³  Lawrence Sena Tuglo⁴  Charles Agyemang⁵  Felix Chilunga⁵ 

[1]Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

[2]Department of International Services, Deutsche Gesellschaft fur Internationale Zusammenarbeit, Accra, Ghana

[3]Department of Medicine and Therapeutics, College of Health Sciences, University of Ghana Medical School, Accra, Ghana

[4]Department of Public & Occupational Health, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands

[5]Department of Nutrition and Dietetics, School of Allied Health Science, University of Health and Allied Sciences, Ho, Ghana

[6]Department of Epidemiology, School of Public Health, Nantong University, 9 Seyuan Road, Nantong, Jiangsu, China

[7]Department of Public & Occupational Health, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands

关键词: Multilevel and multicenter assessment;    Health care system capacity;    Cardiovascular diseases;    Ghana Heart Initiative;   

DOI  :  10.1186/s12872-023-03430-5

 received in 2023-05-28, accepted in 2023-08-05,  发布年份 2023

来源: Springer

【 摘 要 】

IntroductionCardiovascular diseases (CVD) remain the leading cause of death worldwide, with over 70% of these deaths occurring in low- and middle-income regions such as Africa. However, most countries in Africa do not have the capacity to manage CVD. The Ghana Heart Initiative has been an ongoing national program since 2018, aimed at improving CVD care and thus reducing the death rates of these diseases in Ghana. This study therefore aimed at assessing the impact of this initiative by identifying, at baseline, the gaps in the management of CVDs within the health system to develop robust measures to bolster CVD management and care in Ghana.MethodsThis study employed a cross-sectional study design and was conducted from November 2019 to March 2020 in 44 health facilities in the Greater Accra region. The assessment covered CVD management, equipment availability, knowledge of health workers in CVD and others including the CVD management support system, availability of CVD management guidelines and CVD/NCD indicators in the District Health Information Management System (DHIMS2).ResultsThe baseline data showed a total of 85,612 outpatient attendants over the period in the study facilities, 70% were women and 364(0.4%) were newly diagnosed with hypertension. A total of 83% of the newly diagnosed hypertensives were put on treatment, 56.3% (171) continued treatment during the study period and less than 10% (5%) had their blood pressure controlled at the end of the study (in March 2020). Other gaps identified included suboptimal health worker knowledge in CVD management (mean score of 69.0 ± 13.0, p < 0.05), lack of equipment for prompt CVD emergency diagnosis, poor management and monitoring of CVD care across all levels of health care, lack of standardized protocol on CVD management, and limited number of indicators on CVD in the National Database (i.e., DHIMS2) for CVD monitoring.ConclusionThis study shows that there are gaps in CVD care and therefore, there is a need to address such gaps to improve the capacity of the health system to effectively manage CVDs in Ghana.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023