Improving Non-Communicable Disease Patient Care in Low- and Middle-Income Countries

Moving Non-Communicable Disease Care Forward

A hospital room with a sign on the wall.

In partnership with health specialists and stakeholders around the world, we seek to sustainably improve local prevention, management, and treatment standards of cardiovascular and other non-communicable diseases.

The impact of Non-Communicable Diseases (NCDs) continues to grow steadily, with NCDs collectively responsible for 70 percent of deaths worldwide. One of the most prominent subsets of NCDs are cardiovascular diseases (CVDs), which are the number one cause of death globally. Between 1990 and 2013, Sub-Saharan Africa was the only geographic region of the world where CVD deaths increased – the CVD burden in Sub-Saharan Africa continues to rise and is projected to double by 2030.

 

Considering the severity of the impact of NCDs, it is therefore unsurprising that the World Health Organization has declared this growing health crisis a major obstacle to sustainable development and is working to reduce premature mortality from NCDs, including CVDs, by one third in 2030. To support this effort, Bayer joined 21 other pharmaceutical companies to found “Access Accelerated. Moving NCD Care Forward,” an initiative aimed at improving access, prevention, and care for patients with NCDs in low- and middle-income countries (LMICs).

 

 At Bayer, we aim to enable broader patient access to our medicines and treatments worldwide to make our vision of “Health for All, Hunger for None” a reality. And as part of our support of Access Accelerated and commitment to moving NCD care forward, we are drawing on our strong heritage in cardio health treatments to enhance awareness and improve infrastructure in order to tackle such diseases in West Africa.

 

One such example can be seen in our partnership with the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH to establish the Ghana Heart Initiative (GHI). With support from the Ghanaian Ministry of Health and Ghana Health Service, the GHI aims to improve risk assessment and management of CVDs at tertiary, secondary, and primary levels of care in public health facilities in Ghana. The GHI represents a lighthouse project, helping us to better understand access components beyond drug availability and serving as a foundation and catalyst for subsequent initiatives around NCD capacity building.

The Ghana Heart Initiative is a capacity-building initiative to improve cardiovascular diseases care in Ghana starting with the Greater Accra Region and then, hopefully, we will be able to roll it out to other regions and then also to other parts of Africa. One of the key components of the GHI is training.
Dr. Alfred Doku
,
consultant cardiologist

In order for capacity-building projects such as the GHI to be effective, we see a few criteria as being key:

  • Addressing local needs, following a locally-driven needs assessment

  • Full local governance and buy-in

  • A data-driven, systematic approach with measurable output

  • Scalable interventions with defined outcomes

  • An aim to sustainably strengthen the local system towards self-reliance

 

For the GHI, these criteria manifest themselves within four primary focus areas:

  • Establishing National Guidelines: Collaborating with the Ministry of Health to jointly develop national guidelines for risk assessment and management of CVDs to direct healthcare professionals in shaping their practice. Furthermore, these guidelines were used to develop training material, enabling the capacity development of health service professionals and providers in each district.

    • Thanks to the efforts of those involved, these guidelines have already been created and approved and served as the foundation for a recently developed “Facilitator’s Guide” for CVD training.

 

  • Strengthening Health System Capacity: Training and providing resources to further instruct healthcare workers in the latest CVD risk assessment and management standards, to enhance the capacity of health systems to meet the needs of patients.

    • We are helping with the implementation of a well-designed training approach to enable local governments to promote country-wide adoption. Blended learning approaches – including e-learning systems – can be used to scale-up the project to the entire country. To date, more than 650 health professionals have already been trained as part of this effort. 

 

  • Improving Infrastructure: Improving citizens’ access to CVD treatment through the procurement of essential equipment and monitoring of data.

    • The GHI has already begun to provide equipment for diagnosis and management of CVDs in the participating health facilities. 

 

  • Creating a Support Center for CVD Management: Ensuring health professionals have access to professional medical support around the clock via a dedicated support center for CVD management. In order to support health professionals at various levels in managing risk factors and preventing and managing complications, the project also envisages a free telephone support service for health workers.

    • Since the founding of the GHI, we have already established a 24/7 support center for CVD management and have improved nation-wide data management.

 

GHI Trailer

 

The GHI aims to deliver clear outcomes in line with the UN Sustainable Development Goals 3 (Good Health & Well Being) and 17 (Partnerships for the Goals). Following the successful implementation of the pilot phase in the Greater Accra Region, the GHI is now in its roll-out phase covering the entire country.

 

The precise targets of the GHI rollout in Ghana are as follows:

  • 1,150 health professionals trained

  • 55 expert trainers qualified

  • 40 larger health facilities improved

  • Up to 80 low-level community-based health facilities improved

  • Equipment provided to participating health facilities

  • E-learning module developed

 

In our continued support of the GHI, we will transparently share the impacts and outcomes of this initiative on this website.

 

The University of Heidelberg has been contracted to evaluate the impact of the Ghana Heart Initiative. The university will capture the intervention's implementation processes, outcomes, and costs by adopting an implementation science perspective. The results of the evaluation study will support the effectiveness of the GHI interventions and help understand the overall impact of the GHI activities on the healthcare system in Ghana. It will also provide insights into areas for development and the cost of implementing this initiative in other regions. The scientific study will contribute massively to the sustainability of prevention, diagnosis, and better management of CVDs in Sub-Saharan Africa.
 

We are happy to report that in March 2020, the GHI was able to donate medical equipment to 44 hospitals in the Greater Accra Region towards the treatment of cardiovascular diseases (CVDs). The equipment included defibrillators, patient monitors, weighing scales with height meters and glucometers. Kwaku Agyemang-Manu, the Minister of Health, spoke at the event, as did the GHI Project Director, Dr. Alfred Doku, and the GIZ Ghana Country Director, Regina Bauerochse Barbosa.
 

Watch the following video, to see how GHI's equipment donations changed the healthcare experience in the Korle Bu Teaching Hospital.