In 2014, the national STEPwise survey in Uganda revealed that 24.3 per cent of Ugandans had elevated blood pressure and the country's hypertension rate was at 37 per cent.
According to the survey data, 70 per cent of the respondents had never had their blood pressure measured, while 76.1 per cent of those with raised blood pressure were untreated. In addition, the study revealed that majority of the people with high blood pressure were not aware of their status and that approximately one in 10 have more than three risk factors for hypertension.
It is against this background that Healthy Heart Africa, an innovative programme under AstraZeneca, has launched in Uganda to help prevent and control the increasing burden of cardiovascular diseases, with major emphasis on hypertension (high blood pressure) and diabetes. The official launch took place at Protea hotel in Kampala, following a memorandum of understanding signed between AstraZeneca and the ministry of Health in May this year in partnership with Uganda Protestant Medical Bureau (UPMB).
One of Uganda's persistent problems when it comes to non-communicable diseases is the inadequate access to health facilities, especially for upcountry residents that still have to travel to Kampala for specialized care. They will be glad to know that the programme has already launched in South Western region (Mbarara), Eastern region (Jinja) and Central region (Mityana).
According to Dr Allan Mackenzie, the AstraZeneca representative in Uganda, the partnership is designed to strengthen provision of services for hypertension including awareness of lifestyle risk factors.
"We are going to do this through key pillars like increasing awareness, support [of ] the health system to be able to have the capacity, policies, treatment guidelines and equipment and also ensure sustainable access to treatment through the existing channels... training health care workers so that they know how to properly diagnose hypertension and bring them closer to the people and simplify treatment algorithms at primary care level," he said.
He said the programme is going to strengthen the data-collection mechanisms for non communicable diseases (NCDs) across the region and use that data to know the burden of cardiovascular diseases and, therefore, use it to formulate policy decisions that can help in fighting NCDs at national level.
Through the programme, local communities, places of worship, markets and other public places will receive free screening and treatment for high blood pressure, diabetes and respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD) as well as get educated about these diseases and their risk factors.
Ashling Mulvaney, vice president, Sustainability and Access to Health Care at AstraZeneca, said Covid-19 has highlighted that partnerships and investments in healthcare need to be targeted towards prevention and sustainable treatment provision in order to build resilient health systems.
"Our partnership with the ministry of Health and Uganda Protestant Medical Bureau will work to address this gap and tackle low awareness levels of NCDs and their risk factors in the country. Ultimately, our aim is to work together to reduce deaths and disabilities caused by hypertension and cardiovascular diseases and decrease presentation of NCDs at late stages," Mulvaney said.
PARTNERSHIP WITH UPMB
AstraZeneca has partnered with the Uganda Protestant Medical Bureau (UPMB), an organization for health facilities affiliated to Protestant churches in Uganda, to implement the Healthy Heart Africa programmes in the country. UPMB is so far implementing the programme in 35 health facilities that include four public facilities and 31 UPMB facilities across three regions (11 in South Western and Central regions and 13 in the Eastern region).
Also, 128 health workers and 215 Village Health Teams (VHTs) have been trained in those regions, 52,150 people were screened for hypertension and out of those found with the condition, 15,000 have been linked to health care and 2,400 screened for asthma with 360 linked for health care.
Dr Tonny Tumwesigye, the executive director of UPMB, said, "This launch is a momentous occasion as our partnership with Healthy Heart Africa programme is an opportunity to bring cardiovascular healthcare closer to the people. Approximately 80 per cent of our 302 member health institutions are located in rural and poor communities and we will leverage this to implement community- based interventions and improve access to health care in vulnerable ￼￼￼communities as well as strengthen health systems through training of health care providers."
The archbishop of the Church of Uganda Most Rt Rev Dr Stephen Kaziimba Mugalu who was represented by the bishop of Ankole diocese Rt Rev Sheldon Mwesigwa at the launch appealed to the government through the ministry of Health to intensify public health education and increase the budget and support for the Uganda Heart Institute to make it affordable for more Ugandans.
Bishop Mwesigwa said the Anglican Church will implement the programme throughout their health facilities across the country and be a link between the community and health service providers, and not only will people access the services from health facilities but they will also be able to be screened for NCDs from the church premises when they go to pray.
MINISTRY OF HEALTH ON BOARD
According to Dr Gerald Mutungi, the assistant commissioner, NCDs at Ministry of Health, said 33 per cent of deaths in Ugandan hospitals are due to NCDs, more so cardiovascular complications such as hypertension, but what is more worrying is that 76 per cent of people with hypertension do not know that they have it and yet 50 per cent of the time the disease can be prevented by simple measures like healthy diets, exercise, reducing alcohol intake, cutting out tobacco and other substance abuse, and going for regular health checkups, among others.
Dr Diana Atwine, permanent secretary at the health ministry, said the programme has come at a time when they are thinking of taking health services to household level through community health interventions. The ministry also has a target of increasing the number of people who know their blood pressure status, diabetes, obesity and cholesterol levels.
She said the partnership is going to help the ministry achieve these goals through increased awareness of to the public, enhanced screening of cardiovascular diseases, increased early detection and treatment of NCDs and, therefore, reduced mortality. Once the quality of cardiovascular care provided by health workers in lower health units improves, Atwine believes, there shall be less need for costly referrals to big health facilities.
"Non-communicable diseases are becoming an increasing burden on our healthcare system and their increase is being attributed to lifestyle changes. The 2014 STEPwise survey pointed to a high prevalence of risk factors such as tobacco use, alcohol abuse and obesity among respondents calling for need to increase and sustain awareness and prevention campaigns in Uganda," she said.
Since launching in Kenya six years ago and subsequently expanding to Ethiopia in 2016, Tanzania in 2018, Ghana in 2019 and Uganda in 2020, Healthy Heart Africa has conducted at least 15.5 million blood pressure screening in communities and health facilities, trained more than 7,290 healthcare workers to provide education and awareness, screening and treatment services, activated 800 healthcare facilities and identified over 2.8 million elevated blood pressure readings.