Hypertension: Experts advocate strengthening PHCs to curb fatalities
The Nigerian Heart Foundation (NHF) and medical experts have advocated strengthening of Primary Health Care (PHC) centres nationwide to tackle the increasing rate of hypertension-related risks and fatalities in the country.
The experts spoke at the NHF two-day Roundtable on Management of Hypertension in Nigeria on Wednesday at the Nigerian Institute of Medical Research (NIMR), Yaba, Lagos.
The roundtable was titled: “Strengthening Primary Health Care System Through Task Shifting and Basic Health Care Provision Fund (BHCPF).”
Reeling out recommendations after intense discussions by experts from various fields of medicine, Dr Kingsley Akinroye, the Executive Director, NHF, said the meeting called for inclusion of hypertension in the BHCPF/State Social Insurance Scheme.
He added that the experts also demanded inclusion of routine screening for hypertension and identification of risk factors at the PHC.
Akinroye added that the meeting recommended provision of adequate and appropriate equipment, human and financial resources at the PHC centres as well as two-way referral system between the PHC and secondary/tertiary healthcare facilities.
He said medical experts also advocated increased commitment to include People Living With Cardiovascular Diseases (PLWCVDs) in decision making process on access to hypertension care, screening and treatment domestication and practical implementation of Task Shifting Task Sharing (TSTS) Policy.
He added that the experts called for streamlined guidelines for the management of hypertension, widespread advocacy for front of package labelling as well as standardised use of simple treatment protocols at the PHC and Secondary Health Care (SHC) level.
Akinroye added that the meeting called for an adoption of a simplified model of treatment for hypertension, training and retraining of health care workers at PHC level as well as increased access to medication and medical devices at PHC and community level.
He said the experts also called for increased government funding for the management of hypertension, leveraging community health intervention service as well as improving hypertension data implementation on the national data base.
The executive director also listed domestication of World Health Organisation pact strategies, collaboration with all stakeholders involved in hypertension, improving telemedicine for the management of hypertension as parts of recommendations.
He added that the meeting advocated development of a policy on salt consumption and reduction, creation of awareness on salt consumption as well as encouraging partnership with telecommunication providers for the management of hypertension.
Meanwhile, Dr Adeniyi Oginni, the Executive Secretary, Osun State Health Insurance Agency, who harped on the need for integration of BHCPF in the management of hypertension, said the disease remained a major cardiovascular disease in Nigeria.
He said: “Successive governments had neglected primary health care and this had multiplied the burdens on tertiary health care, who were now overwhelmed with medical issues that should have been taken care of at the PHC.
“There must be direct facilities funding to strengthen PHC to provide quality service through improved infrastructure and Human Resources.”
Representing the World Heart Federation (WHF) at the meeting, Ms Elisa Codato, Hypertension Programme Officer, WHF, said the federation would continue its collaboration with NHF on management of hypertension and cardiovascular diseases in Nigeria.
Codato, who stated that the aim was to improve the situation of hypertension management in Nigeria, said the priority area was strengthening of PHC as the main point of entry for patients.
“Communities should be reached with hypertension prevention, diagnosis, screening and provision of moral and material equipment to PHC which are closer to the people.
“The standard of the treatment protocols available in Nigeria should be made available at PHCs and scientific message should be translated in local languages of communities.
“Policy makers should also focus on availability of affordable medicine and ensure inclusion of people living with non communicable diseases and cardiovascular diseases into any health policy,” she said.
Several papers were presented by experts and scholars at the roundtable on ways to control hypertension in Nigeria.
They include: “Ongoing Strategies and Programmes for Hypertension Prevention and Care at the Primary Health Care Level in Nigeria,’ ‘Task-Shifting Intervention: An Effective Strategy to Control Hypertension,’ and ‘the Role of Community Health Workers in Prevention, Treatment and Care of Hypertension.”
Others are: ‘Guidelines on Treatment of Hypertension: Existing Programmes and Initiatives on Hypertension in Nigeria,’ Integration of BHCPF in the Management of Hypertension in Nigeria, among others.
Some of the Speakers at the roundtable were: Prof. Isaac Adeyemi, Director, Scientific Affairs, NHF; Dr Akin Adeniyi, President-Elect, International Epidemiological Association, and Prof. Akin Osibogun, Chairman, Lagos State Primary Healthcare Board.
Others are: Prof. Hilda Okojie, Department of Public Health and Community Medicine, College of Medical Sciences, University of Benin, Edo; Prof. Basden Onwubere, Director, Hypertension, NHF, and Dr Enitan Ademuson, Director of Programmes, NHF, among others.
