Intervention being made to tackle cardiovascular diseases

…”Hearts” initiative to be introduced at primary healthcare level

Guyana has now moved to introduce Hearts Technical Package, aimed at strengthening the Health Ministry’s approach to improving cardiovascular well-being at the primary healthcare level.
Hearts in the Americas is an initiative of the countries, led by the Ministries of Health with the participation of local stakeholders and the technical cooperation of Pan-American Health Organisation (PAHO). The Technical Package provides a set of effective, practical interventions for strengthening the management of risk factors for cardiovascular diseases in primary healthcare and also aims to prevent cardiovascular diseases by ensuring reasonable access to continuous, standardised, high-quality care for people at high risk.
It is aligned with and builds on the WHO’s package of essential non-communicable disease interventions and responds to the agreement that sustainable, effective action is urgently required to prevent cardiovascular diseases, through which millions of lives could be saved.
The Hearts Technical Package comprises of six elements which cover areas of: Healthy lifestyle, Evidence-based treatment protocol, Access to essential medicine and technology, Risk-based management, Team care and-Task Sharing and System for monitoring (HEARTS).
In 2018, 50 healthcare professionals from private and public health across all ten administrative regions were trained to take on this new approach in health facilities across Guyana. Since this implementation, doctors from the MOH Chronic Disease Unit have participated in webinars and began the process of raising awareness on the initiative along with involving key stakeholders.
Focal point of high blood pressure and the HEARTS Technical Package Initiative, Dr Michael Pereira explained that the Chronic Disease Unit has since established a system of collecting data to facilitate an easy transfer of data into the Electronic Medical Record (EMR) as this programme is rolled out.
“We have utilised the patients (chronic disease) medical records along with their clinical passport and continuation sheet to keep track of how they have been coping with the disease over the years… This package is at a primary healthcare level which involves physicians and non-physicians and training of these personnel at the selected implementation sites will commence very soon,” he explained.
He further highlighted that there are already more than 30 health centres and various regional hospitals across the country that are currently utilising these chronic disease medical records, continuation sheets and passports.
The MOH is embracing the HEARTS approach with the implementation of same which will be kick-started at seven health facilities: Lethem Hospital, Port Mourant Health Centre, Anna Regina Health Centre, Campbellville Health Centre, Industry Health Centre, Lusignan Health Centre, Eccles Health Centre and Grove Health Centre.
He further added that plans are in place to collaborate with PAHO/WHO to conduct stakeholder meetings with various focal points and training of healthcare providers in delivering effective, high-quality behaviour modification interventions, such as smoking cessation and nutrition counselling, using motivational interviewing techniques which will improve people’s knowledge about CVDs risk factors and complications, as well as to promote the importance of self-care and adherence.
Dr Pereira said that all health facilities will be required to adopt strict measures to ensure that the HEARTS approach is carried out in all aspects. This involves Evidence-Based Treatment Protocols, where treatment algorithms have already been created and will soon be standardised. These protocols will be strategically placed in areas where they can be easily identified and followed by physicians and other healthcare workers across various communities.
Reports from WHO have shown an estimated 17.5 million people in 2012 died from CVDs, and if current trends should continue, the annual number will rise to 22.2 million by 2030. Of these deaths, 80 per cent are due to heart attacks and strokes, and over three quarters occur in low- and middle-income countries where the economic and social burden is highest amongst poor and disadvantaged groups.
The risk factors for CVDs are behavioural factors, physiological factors and social determinants and drivers. The behavioural factors include tobacco use, an unhealthy diet, harmful use of alcohol and inadequate physical activity. Social determinants and drivers focus on areas of income, housing, globalisation, ageing and urbanisation. Meanwhile, physiological factors are high blood pressure (hypertension), high blood cholesterol and high blood sugar or glucose which is linked to underlying social determinants and drivers.
Hypertension is a major risk factor and key driver of CVDs globally. It is estimated to have caused 9.4 million deaths in 2010 but remains widely undetected, undertreated and poorly controlled. (G12)