Burkina Faso: creating new tools to act on hypertension – World Health Organization

In Burkina Faso, around 1.5 million people have or are at high risk of heart disease. Cardiovascular disease (CVD) is responsible for around one-in-three deaths - approximately 20,600 each year - and more than from any other NCD.

One-in-three adults in the country are also estimated to be living with raised blood pressure (also known as hypertension). But despite hypertension being common among the population, only around 30% of people living with the condition receive treatment for it, of whom less than half have their condition under control.

Credit: WHO

Burkina Fasos Ministry of Health has been proactive in tackling the sizeable burden of NCDs to its health system, and has created a directorate dedicated to work on preventing and controlling NCDs. In addition to an integrated strategic plan on NCDs, several national strategies have been launched, including actions on cancer, eye and oral health, mental illness and tobacco control.

However, several challenges to good heart health persist, including the lack of standardised medical protocols, patchy access to basic equipment, essential medicines and consumables needed to diagnose and manage hypertension in primary health facilities.

ForDr Arthur Seghda, a cardiologist at Centre Hospitalier Universitaire de Bogodogo, building health worker skills is absolutely vital:

Credit: WHO

Integrating NCD management into existing health services is critical for patients across Burkina Faso to receive the quality of care they deserve. However, doing so requires the right policies, guidance and training, designed in the context of local health systems. These tools can enable health workers to act on hypertension and other NCDs with confidence.

Although millions of people live with hypertension in Burkina Faso, context-specific training on the condition is not available for health care workers at the local level. For example, few health workers have adequate equipment to monitor people living with hypertension.

In addition, primary health care centres do not routinely assess for CVD risk - a process needed to identify those most vulnerable and tailor treatment in part because practical guidelines for screening, diagnosing and treating heart conditions are lacking.

This lack of strategic planning for NCDs, coupled with high prevalence of hypertension across the country, is a cause for concern. If health care staff cannot access specific equipment and guidance to manage hypertension, it could have serious consequences for health outcomes and patient care.

Although WHO has created a global technical package to help manage cardiovascular diseases, it is necessary to work with countries to adapt this package to local health system contexts.

Against this background, Burkina Fasos Ministry of Health in conjunction with other key partners, such as the Burkinab Society for Cardiology, the Burkinabe Society of Internal Medicine and patient associations, recently set up a project to:

The Kombissiri Health District, located in the Bazga province in the Center-Sud region of Burkina Faso, was chosen as the pilot site. Kombissiri was a vital place to pilot the project, with almost two-thirds of outpatient consultations at the district hospital being for either hypertension or diabetes.

Dr Compaor W.A. Sandrine, a physician in the Kombissiri Health District, believes the use of new tools and training in the districts health and social promotion centers will help improve care for the local community:

Credit: WHO

Over just a few short months, considerable progress has been made. A new protocol and training manual for the management of hypertension were developed for health care workers.

32 health care workers across the Kombissiri Health District, including head nurses, midwives and maieuticians, have been trained in these new tools. This training will help give them the building blocks to embed hypertension management in their health systems.

Credit: WHO

However, using this guidance also relies on having the right equipment to do so. As such, the team worked with 10 local primary health clinics across the Kombissiri Health District, providing them with blood pressure monitors, blood glucose meters, weighing scales and tape measures.

According to Dr Marie Emmanuelle Zour, Director of Prevention and Control of NCDs, Ministry of Health, the pilot project is a real opportunity for Burkina Faso:

Credit: WHO

As Dr Zoure hopes, work will now be undertaken to further strengthen and standardize hypertension care across primary health services, including scaling care to other health districts. This will include setting up data collection systems on capture data on NCD management in primary care.

Finally, to make sure the tools and training remain helpful and effective, the team will continue to work with those 32 nurses and midwives, to learn from their experiences.

Across the Global Week for Action on NCDs (7-13 September 2020), we are sharing stories from the field about why acting on NCDs is so important. These stories have emerged from a recent project funded by the Government of Denmark. Today's story was written by Professor Jean-Marie Dangou and Mr Daniel Hunt. The authors give their acknowledgement and thanks to Dr Marie Emmanuelle Zour, Dr Arthur Seghda and Dr Sandrine W.A. Compaor.

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Burkina Faso: creating new tools to act on hypertension - World Health Organization