Bridging policy and practice in cardiovascular patient education and health communication in Senegal: a SOSECAR Cardiac Rehabilitation Working Group perspective

Cardiovascular diseases are the leading cause of death worldwide, and their control depends on what patients understand and can do between consultations. Patient education and health communication are therefore part of cardiovascular prevention rather than additions to it. International guidance already treats them as part of standard care, including where comprehensive rehabilitation is unavailable, but implementation lags across sub-Saharan Africa, where cardiac rehabilitation reaches very few people and general services are thinly staffed. Senegal shows both sides of this. National guidance defines therapeutic patient education as a structured clinical method, fixes it to defined moments in the care of hypertension and diabetes, and supplies instruments for delivery and evaluation. Structured cardiovascular patient education has been designed, delivered and evaluated locally, and educational material has been produced in national languages for clinical and community audiences. We argue that these assets have not been translated into a standardised, scalable and measurable education and communication pathway across cardiovascular care and examine why at three levels: patient and family, programme and workforce, and system and policy. We propose a three-pillar framework. Contextualise makes education usable by the patients it is intended for. Integrate carries it across the points at which care changes hands. Institutionalise specifies, resources and audits it within the service. The framework calls for protected time, adapted materials and trained staff rather than new facilities. As a practice-informed proposal, it now requires prospective implementation and evaluation in Senegal.