The Nigerian Heart Foundation (NHF) and medical experts have advocated the 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 of NHF, said the meeting called for the inclusion of hypertension in the BHCPF/State Social Insurance Scheme.
He added that the experts also demanded the inclusion of routine screening for hypertension and the identification of risk factors at the PHC.
Akinroye added that the meeting recommended the provision of adequate and appropriate equipment and human and financial resources at the PHC centres as well as a 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 the decision-making process on access to hypertension care, screening and treatment domestication, and practical implementation of the 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 labeling 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 the PHC level as well as increased access to medication and medical devices at the PHC and community level.
He said the experts also called for increased government funding for the management of hypertension, leveraging community health intervention services as well as improving hypertension data implementation on the national database.
The executive director also listed domestication of World Health Organisation pact strategies, collaboration with all stakeholders involved in hypertension, and improving telemedicine for the management of hypertension as parts of the recommendations.
He added that the meeting advocated the development of a policy on salt consumption and reduction, the 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, of 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 the 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 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 messages should be translated into local languages of communities.
“Policymakers should also focus on the availability of affordable medicine and ensure the 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 of 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.
