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Implementing a multisector public-private partnership to improve urban hypertension management in low-and middle- income countries
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
ID
4657547
Author(s)
Boch, J.; Venkitachalam, L.; Santana, A.; Jones, O.; Reiker, T.; Rosiers, S. D.; Shellaby, J. T.; Saric, J.; Steinmann, P.; Ferrer, J. M. E.; Morgan, L.; Barshilia, A.; Albuquerque, E. P. R.; Avezum, A.; Barboza, J.; Baxter, Y. C.; Bortolotto, L.; Byambasuren, E.; Cerqueira, M.; Dashdorj, N.; Dib, K. M.; Guèye, B.; Seck, K.; Silveira, M.; Rollemberg, S. M. S.; de Oliveira, R. W.; Luvsansambuu, T.; Aerts, A.
Implementing a multisector public-private partnership to improve urban hypertension management in low-and middle- income countries
Journal
BMC public health
Volume
22
Number
1
Pages / Article-Number
2379
Keywords
Humans; Public-Private Sector Partnerships; Brazil; Senegal; *Hypertension/epidemiology; *Cardiovascular Diseases; Cardiovascular risk; Hypertension; Population health; Primary care; Public private partnership; Urban health; funded the urban population health initiative and the presented study. The; American Heart Association is a recipient of funding from the Novartis Foundation; for technical assistance and resources to support professional education, quality; improvement, monitoring, and evaluation in this multi-city initiative. The views; expressed in this manuscript are those of the authors and does not represent the; views of the American Heart Association. The Swiss Tropical and Public Health; Institute, the Sociedade de Cardiologia do Estado de Sao Paulo, Intrahealth, YC; Baxter, the Mongolian Public Health Professionals' Association, the Onom; Foundation, the Instituto Tellus and Iqvia are funded by the Novartis Foundation; for contributing to the implementation and / or evaluation of the urban; population health initiative and the study described here. In collaboration with; local and global partner organizations, local health authorities, and medical; societies, the funder led the study design, oversaw data collection and analysis,; publications, and preparation of the manuscript. None of the authors have; declared any additional conflict of interest.
BACKGROUND: Cardiovascular disease presents an increasing health burden to low- and middle-income countries. Although ample therapeutic options and care improvement frameworks exist to address its prime risk factor, hypertension, blood pressure control rates remain poor. We describe the results of an effectiveness study of a multisector urban population health initiative that targets hypertension in a real-world implementation setting in cities across three continents. The initiative followed the "CARDIO4Cities" approach (quality of Care, early Access, policy Reform, Data and digital technology, Intersectoral collaboration, and local Ownership). METHOD: The approach was applied in Ulaanbaatar in Mongolia, Dakar in Senegal, and Sao Paulo in Brazil. In each city, a portfolio of evidence-based practices was implemented, tailored to local priorities and available data. Outcomes were measured by extracting hypertension diagnosis, treatment and control rates from primary health records. Data from 18,997 patients with hypertension in primary health facilities were analyzed. RESULTS: Over one to two years of implementation, blood pressure control rates among enrolled patients receiving medication tripled in Sao Paulo (from 12.3% to 31.2%) and Dakar (from 6.7% to 19.4%) and increased six-fold in Ulaanbaatar (from 3.1% to 19.7%). CONCLUSIONS: This study provides first evidence that a multisectoral population health approach to implement known best-practices, supported by data and digital technologies, and relying on local buy-in and ownership, can improve hypertension control in high-burden urban primary care settings in low-and middle-income countries.
