Executive Summary of theproject
• Non-communicablediseases pose aconsiderable disease burden to healthcare delivery in Africa. They include hypertension, chronic respiratory tract diseases, diabetes, and cancers. The health sector report in 2018 by the GHS demonstrated that cardiovascular diseases and diabetes consistently fall within the top twenty outpatient morbidity. Critical interventions at health systems level are needed to support health systems preparedness for the management of cardiovascular diseases and diabetes at the primary level health facility in Ghana. The project was awarded to HI Foundation and implemented by the Ghana Health Service (GHS)/ Bono Regional Health Directorate. The project was fully funded by German-based non-governmental organization (Pharmacists without borders Germany, "Apotheker ohne Grenzen Deutschland e.V") Overall, the project aims building capacity for screening and management of diabetes and cardiovascular diseases in four selected district Hospitals in the Bono Region. The facilities are Kwatire Government Hospital, Tain District Hospital, the Drobo St Marys Hospital and Wenchi Methodists Hospital
District Hospital Diabetes andcardiovascular diseases project (Training-Phase I)
The training started on December7, 2021, atthe Drobo StMary'ss Hospital, followed by Tain District hospital, Wenchi Government Hospital, and finally, on December 14, 2021, at the Kwatire District Hospital. Across all Hospitals, the facilitating team prior to the training sessions engaged with the hospital management to inform them of the motive of the training as earlier communicated. Again, debriefing meetings were also held with management to solicit their support for implementing post-training action plans in the respective facilities. To a very large extent, participants were cooperative and excited about the opportunity to be trained in cardiovascular and diabetes care. Except for Drobo and Tain District hospitals, Wenchi and Kwatire had the opportunity for pre and post-training assessments. In all the hospitals, action plans were developed according to pre-determined criteria for improving diabetes and cardiovascular disease management.
Key thematic Areas of training
- Team-based approach to the management of hypertension and diabetes in LMICs.
- The burden, aetiology, risk factors, pharmacological and non-pharmacological approaches to management of hypertension.
- The burden, aetiology, risk factors, pharmacological and non-pharmacological approaches to the management of diabetes.
- Nutritional approaches to the management of hypertension and diabetes.
- Cardiovascular risk assessment using the WHO Cardiovascular Risk Assessment tool
There were practical sessions onconducting a risk assessment forpatients using the WHO Afro D cardiovascular Risk assessment tool. Through a series of cases presented by the facilitators, participants practised risk assessment using the tool presented. After this session, participants were assigned into groups to work on action plans and present to the whole group. Facilitators support the participants to design and agree on an effective action plan informed by the needs of the respective hospitals. Following the training, a WhatsApp group was created to include all participants from the four hospitals. This has improved communication between the facilitators and the participants, offered the platform for mentorships, practical guidance on implementing action plans, and sharing of best practices among participants. These activities followed the same trend in all the hospitals where the training was conducted.
District Hospital Diabetes and cardiovascular diseases project (Logistics support Phase III)
The second phase of our CVD &DM program funded by PSF-Germanyand implemented by Bono-GHS & piloted in four Primary level care facilities, was completed yesterday. Participating facilities received clinical logistics worth over 2000Euros to support NCD management. Clinical items provided were adult weighing scales, digital blood pressure devices, lancet devices, stadimeters, glucometers and glucometer strips, manual Blood pressure devices among others. These clinical equipments are critical resources for the screening and treatment of hypertension and diabetes in Ghana. The four participating health facilities are the Tain District Hospital, the Wenchi Methodist Hospital, Drobo St Marys Hospital, and the Kwatire Government Hospital.
District Hospital Diabetes and cardiovascular diseases project (Research -Phase III)
Assessment of gaps in themanagement of hypertension anddiabetes in four district hospitals in Ghana: A multi-centre cardiovascular and diabetes project.
Justification: To inform further project directions, we planned toconduct a study to understand the state of management of CVDs and DMs in the selected facilities. This project-based study explores the gaps in managing hypertension and diabetes in four district hospitals in Ghana. The import of this study is to examine resource deficit and the biomedical status of patients on treatment in the various project sites per the Ghana Health Service (GHS) standard treatment guideline.
Methods:The study adoptsamulti-center cross-sectional approach to assess gaps in managing hypertension and diabetes in the four hospitals in the Bono Region. Medical records (last 12 months) of patients diagnosed with hypertension and diabetes in these four hospitals were retrieved by trained Health information officers using a designed data extraction tool. For comparative purposes, current medical records (last 12 months) of patients diagnosed with hypertension and diabetes in these four hospitals were retrieved by trained Health information officers as well. Again, to aid our understanding of the changes in health status, current three current (last 3 months) blood pressure readings and fasting blood sugar shall be recorded from files (health records) of patients diagnosed with hypertension and diabetes. In accessing resource deficit, a structured questionnaire shall be administered to heads of facilities to assess the availability of logistics and human resources for managing hypertension and diabetes. We used the WHO Service Availability and Readiness Assessment (SARA) tool to record the available logistics and resources for managing the two commonest NCDs.
