Addressing Hypertension Care in Africa
BACKGROUND INFORMATION
Last January, Dr. Cooper, Dr. Commodore-Mensah and Ms. Nancy Molello travelled to Kumasi, Ghana to get a first hand update on the Center for Health Equity’s “Addressing Hypertension Care in Africa” (ADHINCRA) study. The study is testing techniques that apply modern medical technology and intervention techniques to the unique cultural circumstances of rural Ghana. Launched in 2019, the study relies on nurses—rather than doctors-- trained to monitor blood pressure using protocols developed in the RICHLIFE study (see the RICHLIFE update in this newsletter) and to counsel and help patients improve their health.
STUDY PROGRESS
After visiting our research partner, Dr. Fred Stephen Sarfo, and the team at the Kwame Nkrumah University of Science and Technology (KNUST), we are pleased to report that the study is progressing well, has successfully enrolled 238 of the targeted 240 participants, and may be teaching us something about the common nature of humanity!
Over the course of the weeklong visit, the CHE team met with multiple stakeholders of the study, including Dr. Sarfo, the KNUST research team, their partners from Medtronic who created the health management app used in the study, and with the partners at our four clinical sites: Komfo Anokye Hospital, Suntreso Government Hospital, Kumasi South Hospital, and Manyhia District Hospital.
During the trip, Dr. Cooper, Dr. Commodore-Mensah and Dr. Diana Baptiste (JHU SON) also presented on clinical communication strategies, quality improvement and evidence-based practice. An update on cardiovascular health research conducted by the Center was also provided to partners and colleagues at the University of Ghana School of Nursing and Midwifery.
HUMAN CENTERED DESIGN WORKSHOP
Ms. Molello facilitated a Human Centered Design Session with the research team, nurses, and the Medtronic partners to brainstorm ways on overcoming challenges the study team had met. These challenges included difficulties with engaging men in caring for their hypertension, misperceptions about the effectiveness of generic medication, and problems with low health literacy.
The JHU team also met with nurses and study participants in the field during clinic visits. These conversations resonated with the JHU team, and seemed to highlight some of the common challenges health care systems encounter everywhere. One nurse noted that some study participants “were taking spirits. . .others were not doing any exercise... some were not taking any fruits and vegetables,” all unhealthy practices that sounded awfully familiar to Dr. Cooper and her team of public health experts. Another nurse pointed out challenges recruiting patients for the study, especially among males, who wouldn’t follow through on appointments to join despite having high blood pressure. Dr. Cooper quipped that “we have that same problem in the US,” indicating that not doing what’s good for you might be a trait that crosses oceans!
LESSONS LEARNED
And as with effective human health care interventions anywhere, it is making connections that matter the most when working with patients. As one clinician pointed out, “you need a good rapport... good rapport will make the person relax and the person can explain his or her issues to you.”
The patients spoken to were enthusiastic about the study, and were adapting to both the technology and lifestyle changes that were improving their health.
The JHU team returned to the US energized by how health equity is being pursued in Africa, and how this study may provide an approach to treating similar conditions in other parts of the globe.
ADDITIONAL RESOURCES
For more information on ADHINCRA, please see the project page.