The foundation is collaborating with global nonprofit PATH and government agencies in Vietnam to launch the Ho Chi Minh City Communities for Healthy Hearts Program. The program is designed to improve the health of adults with high blood pressure living in low-income households in four districts in Ho Chi Minh City, Vietnam’s largest urban area.
The program is part of the Novartis Foundation’s focus on catalyzing scalable and sustainable healthcare models that improve access and health outcomes to have a transformational impact on the health of the poorest populations.
When people move to urban areas they face increased risk of high blood pressure, due to lifestyle changes, fewer healthy food choices and higher stress levels.
“Communities for Healthy Hearts aims to find innovative and sustainable ways to improve the way hypertension is prevented and controlled in Ho Chi Minh City, by maximizing opportunities for screening, diagnosis and early treatment in the communities, and by empowering patients to take more responsibility in the management of their own health,” says Ann Aerts, Head of the Novartis Foundation.
Heart disease is the deadliest chronic, noncommunicable disease (NCD) in the world. The leading cause of heart disease is high blood pressure, accounting for 9.4 million deaths worldwide every year, which is equivalent to the mortality from all infectious diseases combined.
“This is why PATH is investing in a global strategy on NCDs and is bringing innovation to bear to make these invisible diseases visible to policymakers, affected individuals, families and communities” says Helen McGuire, Director of PATH’s NCD Program.
High blood pressure is a particular problem in low- and middle-income countries, where more than 80% of deaths related to complications from hypertension occur. Rapid urbanization in these countries is a major factor – migration from rural to urban areas is associated with increased blood pressure as lifestyles change, healthy food choices become limited, and stress levels increase when living in overpopulated and underserved urban areas.
Healthcare services in these growing cities are struggling, often swamped with the ongoing challenges like infectious diseases. They have limited time or resources to really tackle chronic diseases like high blood pressure, which often don’t show symptoms early on, yet can cause long-term damage.
The situation in Vietnam reflects this broader trend. “Nearly 25% of the adult population in Vietnam has high blood pressure, but less than half of them are aware of their condition,” says Christina Wadhwani, Project Management Lead for the Novartis Foundation. “And of the people who are diagnosed, only about 11% have their hypertension under control. We hope these activities will at least double the number of patients successfully managing their high blood pressure in the short term and ultimately improve patient outcomes.”
Concrete steps to better blood pressure control
The Ho Chi Minh City program leverages the collective expertise of its partners to create an innovative healthcare model adapted to the needs of low-income patients.
The first efforts began early in 2016, when the project team ran an audience assessment to better understand how much people knew about high blood pressure. The study results formed the basis of an education campaign, with community meetings and radio and TV ads, to create a sense of urgency around the high blood pressure problem and encourage people to take action.
Residents of Ho Chi Minh City currently have very limited options for monitoring their blood pressure and getting medical help to manage hypertension. To address this issue, the project is leveraging existing public and private health services, as well as involving Lotus Impact, to encourage local entrepreneurs to add high blood pressure screening to their existing businesses.
The idea is to help people get access to free screening services and information, where and when they need them – for example in kiosks in convenience stores, gas stations, post offices and hospitals.
“This is the first program to include social enterprises in having a direct impact on health outcomes specific to hypertension,” says James Bui, Founder and Managing Partner of Lotus Impact. “We hope that by engaging private social enterprises to increase access to hypertension screening, we cultivate the existing network of innovation and creativity and result in a positive social return for healthcare in Vietnam.”
New guidelines, new technology, improved outcomes
Once people are diagnosed with high blood pressure, the next hurdle is ensuring access to high-quality care. Together with the Ministry of Health, the project is bringing together international and local experts to update treatment guidelines to better cater to local needs. Once they are finalized, training on the updated guidelines will begin for healthcare professionals across Ho Chi Minh City.
The program will also use technology to help patients manage their disease and stick with their treatments. Patients will be sent reminders on their mobile phones to take medicines, make healthy lifestyle changes and keep follow-up appointments with their doctor. PATH is lending its expertise to help the project successfully incorporate this technology.
“We have a long-standing history with the Ho Chi Minh City Provincial Health Department, with previous public health programs using digital health technology, and we are excited to embark in this new area of hypertension,” says Dr. Truong Bui, Project Director of Communities for Healthy Hearts for PATH. “Through this unique public-private partnership, we hope to address the issue of hypertension as a silent killer in Vietnam.”
The Communities for Healthy Hearts program is the Novartis Foundation’s second hypertension program in a low- or middle-income country. Last year the foundation launched the Community-based Hypertension Improvement Project (ComHIP) in Ghana.
“Overall, the goal in Vietnam is the same as in Ghana,” says Aerts. “We want to make high blood pressure prevention and control easily accessible at the community level – both for health workers and patients – ultimately improving health outcomes.”