Key result
Baseline assessment in Ghana reveals major CVD management gaps, with only 5% achieving blood pressure control.
Why the study?
Most African countries lack capacity to manage cardiovascular diseases, prompting a baseline assessment of the Ghana Heart Initiative to identify health system gaps.
Cross-Sectional (n=85,612)
Yes
The study highlights severe gaps in cardiovascular disease management capacity in Ghana, including profound deficits in equipment, standardized protocols, and blood pressure control rates, underscoring the urgent need for health system strengthening.
Underscores urgent health system gaps in Ghana; leaves open whether targeted interventions can improve hypertension control.
INTRODUCTION: Cardiovascular 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. METHODS: This 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). RESULTS: The 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. CONCLUSION: This 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.
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Doku et al. (2023) conducted a cross-sectional in Cardiovascular diseases (n=85,612). Ghana Heart Initiative baseline assessment was evaluated on Blood pressure control among newly diagnosed hypertensive patients continuing treatment. A baseline assessment of 44 health facilities in Ghana revealed significant gaps in cardiovascular disease management, with only 5% of newly diagnosed hypertensive patients achieving blood pressure control.
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