Improving cardiovascular health in primary care in Saint Lucia through the HEARTS Initiative
Author:
Affiliation:
1. Ministry of Health and Wellness, Castries, St Lucia
2. Pan American Health Organization, Bridgetown, Barbados
3. lawrencp@paho.org
4. Performance Management Delivery Unit, Office of the Prime Minister, Castries, St Lucia
Abstract
To improve blood pressure control and hypertension registry coverage at six demonstration sites in St Lucia.
From January 2020 to December 2021, St Lucia’s Ministry of Health, with support of the Pan American Health Organization, implemented the HEARTS Technical Package in six primary health care facilities with six-monthly monitoring of blood pressure control and hypertension registry coverage. The modules included healthy-lifestyle counselling, evidence-based treatment protocols, access to essential medicines and technology, risk-based cardiovascular management, team-based care and systems for monitoring.
Levels of blood pressure control at 6, 12, 18 and 24-months after the intervention were 37.1%, 28.9%, 33.9% and 36.5% respectively. Hypertension registry coverage increased by 17.8% (1 434 to 1 689) for patients accessing service. Implementing the monitoring for action initiative 12 to 15 months after the start of the intervention resulted in policy and operational changes, improved documentation, and provided accurate and reliable data.
The HEARTS initiative unearthed basic infrastructural challenges in blood pressure control. The essential elements for success were (1) buy in at all levels of the health sector; (2) addressing policy and operational changes; (3) accurate documentation and required analysis; (4) standardization of equipment and procedures and (5) regular monitoring and evaluation. Capacity building underpinned all changes.
Publisher
Pan American Health Organization
Subject
Public Health, Environmental and Occupational Health
Link
https://iris.paho.org/bitstream/handle/10665.2/56270/v46e1282022.pdf
Reference9 articles.
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2. Pan American Health Organization/World Health Organization. STEPS Noncommunicable disease Risk factor Survey, Data book for Saint Lucia 2019 (forthcoming).
3. Fuchs F, Whelton P. High Blood Pressure and cardiovascular disease. Hypertension. 2020;75(2). Available at: https://doi.org/10.1161/HYPERTENSIONAHA.119.14240 [Accessed 20 March 2022].
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5. Schiffrin E, Campbell N, Feldman R, Kaczorowski J, Lewanczuk R, Padwal R, Tobe S. Hypertension in Canada: Past, Present, and Future. Ann Glob Health. 2016;82(2):288-299.
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1. HEARTS in the Americas: Targeting Health System Change to Improve Population Hypertension Control;Current Hypertension Reports;2023-12-02
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