The Healthy Heart Africa (HHA) program—developed by AstraZeneca and currently active in Ethiopia, Ghana, Kenya, Tanzania, and Uganda (and with agreement to launch in Côte d'Ivoire and Senegal)—aims to reduce the burden of hypertension by working with local health systems to ensure sustainable linkages to diagnosis and treatment for persons with elevated blood pressure.
In Ghana, the national health service and PATH are implementing HHA together. Since July 2019, the program has screened more than 817,000 people across 35 facilities in Ashanti, the most populated region of Ghana, and linked more than 165,000 with elevated blood pressure to health systems for diagnosis, treatment, and support.
"We made strong progress at the start, but the COVID-19 pandemic and its restrictions made it difficult to conduct the community-based outreach activities typically employed," says Helen McGuire, PATH's Noncommunicable Diseases (NCDs) program director. "On top of that, patients have been more reluctant to seek care for NCDs, which can create significant problems for disease control."
Stepping up during the pandemic
To overcome pandemic disruptions, AstraZeneca proposed that partners reallocate funding to provide personal protective equipment to HHA facilities in Ashanti; support education and awareness-raising about safety protocols; provide information on the increased COVID-19 risks faced by people living with NCDs; and encourage people in the community to remain adherent to their treatment regimens and blood pressure monitoring.
Through the application of these measures, PATH and the Ghana Health Service were able to provide COVID-19-safe screening for 650,717 people and link nearly 150,000 to hypertension care. The program also employed innovative approaches such as the integration of hypertension screening during the first phase of the COVID-19 vaccine rollout.
“This integration of services, which makes getting care easier, is critical for improving primary health care systems,” said PATH’s director of Primary Health Care, Kim Green, PhD.
Priority groups targeted for vaccination in this phase included frontline health workers, people with underlying comorbidities, and people aged 60 years and above. Patients visiting any one of eight HHA-designated facilities for vaccination would go through a triaging area where temperature checks, COVID-19 risk assessments, and blood-pressure screenings before they proceeded to the vaccination point.
“Healthy Heart Africa is making a tremendous impact in ensuring access and continuity of care for hypertension patients.”— Helen McGuire, NCD Program Director, PATH
This strategy was effective in reaching priority groups who were unaware of their hypertension status. The program also integrated hypertension screenings during advocacy events such as World Hypertension Day and World Heart Day as a means of maximizing opportunities for screening, linkage, and diagnosis.
Though the COVID-19 pandemic has strained health systems and highlighted the increased vulnerability of people living with NCDs, it has also created opportunities for evolving programs and consolidating critical health services to better meet community needs.
“The capacity for screening, early diagnosis, and treatment is critically important for health system resiliency,” says Kim. “Access programs like Healthy Heart Africa in Ghana can play an important role in that resiliency.”