Nairobi, Kenya—As a single mom, Fascoline Wanjiku can’t afford to get sick. And when her hypertension flares up, she isn’t the only one who suffers.
“When I am unwell, I can’t even go out to look for work, so my children are always sent home for lack of school fees. At times like these, they just stay at home until I get better and send them back to school,” said the mother of three.
The World Health Organization estimates that 46 percent of adults over 45 in Africa have hypertension, a high blood pressure disorder that if left unchecked can lead to more serious and chronic heart disease—and death. In Wanjiku’s native Kenya, 35 percent of women are at risk for high blood pressure.
A mother who dies of a stroke caused by high blood pressure jeopardizes the health and safety of her children. A wife whose husband suffers a fatal or near-fatal heart attack may be left on her own to feed her family. All in all, communities with high rates of heart disease and hypertension face serious challenges in meeting or exceeding their potential. Kenyan health authorities and local governments, recognizing the social and economic costs of high blood pressure, are supporting HEALTHY HEART AFRICA (HHA), a new, sustainable program, designed by AstraZeneca, to promote and increase access to early screening for hypertension in sub-Saharan Africa.
Hypertension is known as the “silent killer” because at least a third of people who have it are unaware that they have the disease. HHA is determined to change that scenario by integrating routine screening for high blood pressure and cardiovascular disease into outpatient and other services, including maternal health care, to prevent deaths. The goal of the 18-month program, which began in late 2014, is to scale up these services across Kenya and Africa and save lives. This innovative program represents a unique partnership between AstraZeneca, Jhpiego, PSI, Abt Associates and four local organizations—Amref Health Africa, AMPATH, Christian Health Association of Kenya, and Mission for Essential Drugs and Supplies.
In the first month of the program’s operation, an estimated 14,000 people in two counties had been screened at community and county health facilities
Dr. Evelyne Kimani, Director of Programs for Kiambu County, summed up the promise of HHA: “With this program in place, we have hope to curb hypertension in the county.”
Jhpiego, the technical lead on the project in Kiambu and Kirinyaga Counties, has trained an estimated 500 health care providers, community health workers and volunteers to educate communities on hypertension and carry out screenings, assessments and referrals. And although monitoring blood pressure may appear to be a routine task, newly trained providers such as Sister Margaret Wairimu Muchui can attest to the difference the HHA approach has made in her practice.
“I have changed very much since being trained by the HEALTHY HEART AFRICA program,” said Sister Margaret, a nurse at the Tigoni Sub County Hospital, one of 15 sites where screening occurs. “Now while people are waiting [for services], they get a health talk about hypertension. Before I didn’t talk with them. But now, I greet the patients, ask them a question, welcome them and explain what I am doing, so that they can feel calm and I get a good reading.
“I make them relax, and it even makes them feel more welcome in the hospital. When we do the talk and they find out that hypertension can be handled properly, lowered and managed, then they are no longer afraid to get screening.”
Since the program began, about 60 people a day are screened at Tigoni, said Sister Margaret. “We are all excited [about the program] because we feel like it is touching a real need.”
HHA is providing the latest in blood pressure monitoring equipment and offers discounted drugs so Kenyans can actually afford the medicine they need. That kind of support is having an impact on demand for the service. Just ask Community Health Volunteer Richard Kariuki.
“Before, when we were doing home visits, people were telling you that they have headaches or that they don’t feel so well,” said Kariuki, who works in the Tigoni District. “Maybe we would refer them to the hospital. The HHA program sensitized us and told us that hypertension is a big problem in our community. People are very interested. It’s new for them. I am very happy to have my own station in the hospital where we actually have what we need to screen them. I think people will be open to change their lifestyle and diet. People want to get checked if they know there is hope to get good medicines.”
Here is what vegetable seller Susan Muthoni Kamau, 50, tells her customers at the market: “My message to other people is that you can be happy and have a good family. If you have hypertension, just start your doses and you can feel better.”
The HHA program, she says, will cut her monthly prescription drug cost from $27 to $3. “That would be very helpful. With my six children, I have so many things to take care of. That would help me to take care of me so that I can get on with my life and be hopeful.”
Jhpiego staff Everlyne Njeri, Stephen Maina, Teresia Mutuku, Manya Dotson and Nancy Koskei contributed to this article.