Preventing High Blood Pressure in Nairobi Slums

October 16, 2013

April 5, 2013

‘Who has measured his/her blood pressure in the last year?’ The crowd of people looks around and back to the speaker, but no one raises his/her hand. ‘Who knows exactly what their blood pressure is?’ Still no hands go up in the air, the majority of faces look puzzled and a bit anxious. This is one of the typical scenes during the awareness campaign of the cardiovascular diseases study APHRC did last year in the slums of Nairobi (Korogocho and Viwandani).

Although high blood pressure also known as hypertension and related cardiovascular diseases are the most common causes of death worldwide, there are still entire populations who are not aware of this growing silent epidemic.

According to the WHO, more people die from cardiovascular diseases in SSA (12.5%) than from HIV/AIDS (12.3%) or malaria (7.3). The African Population and Health Research Center (APHRC) conducted research in two informal settlements in Nairobi (Korogocho and Viwandani slums) revealed that 1 out of 10 adult residents are battling high blood pressure. Shockingly, most people were not aware of their conditions thus the need to create awareness

In the slums of Nairobi over 80 percent of the people with hypertension are not aware of their blood pressure being elevated — this lack of awareness can kill. What is even more concerning is that the lack of knowledge about hypertension is that it is not just among patients, but also among nurses, clinical officers, policy makers and health care organizations.

Awareness and Screening in the Slums:

Educating communities and health practitioners was one of the reasons APHRC and partners decided to start the SCALE UP study (Sustainable Model for Cardiovascular Health by Adjusting Lifestyle and treatment with Economic perspective in the settings of Urban Poverty)—a study to determine a cost-effective intervention to prevent cardiovascular diseases, specifically by screening on high blood pressure and providing medication for hypertension in poor urban areas.

In the first phase of the project focused on raising awareness about hypertension by organizing baraza’s in the seven different villages in Korogocho. Community health workers were collaborated with community leaders to gather big crowds and explain about the intervention and the importance of getting screened on hypertension. Even community leaders did not know the status of their blood pressure and sometimes they were the first in the village to get screened, and in most cases they had worrying high blood pressures. More than half of the community leaders were sent straight away to the health center for further investigation and possible treatment. Besides the barazas, community health workers visited churches, mosques and other religious places to spread the message on the importance of participating in the intervention, and for several weeks the local radio station, Koch FM, broadcasted several times per day a specific jingle to raise awareness with a tag message know your blood pressure today !

Successes and Challenges:

As a result of the study and the hard work of more than forty community health workers screening everyone in the overall population of Korogocho above 35 years old we have  seen significant progress in the screening of blood pressure in the community.  The majority of the people welcomed the community health workers into their homes and were thankful for the screening. The main challenge of the intervention was to reach the whole population at risk. Once again it became clear that many slum dwellers live very mobile lives in order to earn an income. Some individuals leave home before six in the morning and returning after ten at night, which made it very difficult to find them at home to do the screening.

Another major challenges was the sheer size of the study. With 6700 people estimated at age 35 years and above being screened as part of the study. After five months of hard work and tightened  security during late night visits more than four thousand people were successfully screened as part of the study.

What did we find?

Raising awareness and doing screening in the slums revealed some  startling fingdings: Out of those 4,000 people we screened, more than eight hundred people were diagnosed with elevated blood pressure and were issued a voucher for free treatment in order to further investigate and receive treatment at the local health center. Thanks to the support from so many community health workers more than half of those 800 patients showed up in the clinic and received medication. APHRC studies  indicates that 1 out of 5 adults aged over 35 years  and above are either diabetic or hypertensive.

The SCALE UP study continued to screen and test a high number of people today. We are happy that the awareness of the importance of blood pressure is slowly finding its way in Korogocho slums. Hopefully thanks to the hard work of health workers and community leaders the community will reduce their risk of getting cardiovascular diseases in the near future.

The government of Kenya needs to move with speed and curb the fast sprouting illness through training health practitioners on basic screening skills as well as increasing the number of health facilities within communities and especially in the urban slums for ease of medical access.

If you  were not part of the study and have not yet measured your blood pressure, then please make sure you visit a nurse or clinical officer in your areas as soon as possible to get screened.

Take responsibility of your health, you have only one life.

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