Cardiovascular HP and Chronic Disease Prevention in Africa

Introduction

This page is the result of a six-year effort to build capacity for cardiovascular health promotion and chronic disease prevention and control in the African region supported by the IUHPE and the US Centers for Disease Control and Prevention (CDC).

The IUHPE and the CDC continue to support this initiative through the present platform:

  • To encourage sustained communication and ongoing coordination efforts in the sub-Saharan African region to prevent and control cardiovascular disease,

  • To serve course participants' needs for a resource base and a liaison / communication tool for connecting experts, practitioners and the participants themselves,

  • To provide up to date information,

  • To assist participants to communicate with each other and more broadly with IUHPE members,

  • To provide an easy home for all materials developed and shared at the Annual Seminars (training course tools and resources, presentations, key references from the literature, evaluation processes, findings, lessons learnt and recommendations),

  • To facilitate transfer of knowledge, tools and processes to other low and middle income countries,

  • To facilitate and advocate for the benefits of cardiovascular health promotion and cardiovascular disease (CVD) and risk factors prevention,

  • To be a resource for anyone else interested in Cardiovascular Health Promotion in the African region.

 

Webpage content:

 

Annual seminars

Background and Rationale

The emergence of a double burden of communicable and non-communicable diseases increasingly threatens the African region. By acting now, we can prevent cardiovascular diseases (CVD) from becoming the same burden in Africa that it is elsewhere around the globe. In fact, many regional and international actors are now multiplying their efforts to promote health in Africa.

 

Following an initial consultation with experts within Africa, and from around the world, the CDC/IUHPE Annual Seminars on Cardiovascular Health Promotion were developed to address this identified need to build capacity and increase knowledge. The course was designed to help establish strategies that contribute to preventing and controlling CVD in the Sub-Saharan Africa region. In addition, this unique initiative was intended to build in-country capacity and a locally-sustainable infrastructure for CVD and risk factor disease surveillance, and cardiovascular health promotion development.

 

About the course

Since 2004, the seminars have been held in both West and East Africa. Each year, four to five multi-disciplinary country teams were trained in Cardiovascular Health Promotion and Chronic Disease Epidemiology. The West African seminars were held in Ghana between 2004 and 2006 and included teams from Ghana, Gambia and Nigeria. The East African seminars were successively held in Kenya, Tanzania and Uganda between 2007 and 2009, with representatives from all three countries attending every year.

 

The objective of the seminar series was to build and strengthen the capacity, knowledge and skills of trained country teams:

  • To address the increasing non-communicable disease (NCD) burden of heart disease, stroke, and diabetes using population-based health promotion programmes and policies;

  • To advocate for public health policies;

  • To promote healthy lifestyles; To create environments that support and facilitate improved disease prevention and the reduction of risk factors in respective countries.

 

The course was structured around five major areas:

  • General principles of:

    • Health promotion and chronic disease prevention in Africa;

    • Basic public health and epidemiology;

    • Surveillance for CVD and risk factors in the African context;

    • Evaluation plans and designs;

    • Project development (core principles and expectations);

  • Prevention of specific diseases and risky behaviours;

  • Partnerships;

  • Data collection and methods;

  • Communication, advocacy and social marketing.

 

At the end of the course, the trainees are expected to:

  • Understand the principles and practice of NCD surveillance;

  • Understand the principles of health promotion for NCD control;

  • Have acquired a comprehensive knowledge of the epidemiology of cardiovascular disease in Africa;

  • Understand how to build/work with a multi-disciplinary team to achieve health promotion goals;

  • Be able to formulate a plan for CVD risk factor control;

  • Be able to train other health professionals.

 

As part of the seminar, each team developed their own health promotion and CVD prevention projects. After the seminar the trainees further developed, and implemented when possible, the team projects in their home countries.

 

 

Course Presentations

Please note several of these files may take a while to download.

 

Click here to see the key references

 

Related areas

Surveillance

More surveillance data and information on surveillance systems is available at the following pages:

 

Risk Factors

Some of the major risk factors for Cardiovascular Diseases (CVD) and other non-communicable diseases (NCDs) include:

  • Tobacco,

  • Hypertension,

  • Diabetes,

  • Psychosocial and environmental factors,

  • Physical Inactivity,

  • Poor Nutrition,

  • Obesity,

  • Other risk factors.

You can find more information on NCDs and risk factors at Infobase (WHO): http://www.who.int/infobase/report.aspx.

 

Social Determinants of Health

The greatest cause of disease is attributed to the social conditions in which people are born, grow, live, work and age. In fact, almost all major diseases, including CVD and diabetes, are determined by a complex mesh of risk factors and these social conditions, known as social determinants of health (SDH), which are themselves shaped by the distribution of money, power and resources at all levels (global, national and local) and influenced by policy choices.

Health disparities within countries, and the marked health inequities between countries, are caused by:

  • Structural factors: Unequal distribution of power, income, goods, and services; observed both globally and nationally

  • Social Inequities: Unfair access to and inequalities in quality of health care, schools, education, housing, working conditions, communities, urban and rural environments, and chances of leading a flourishing life.

Together, the structural determinants and conditions of daily life constitute the social and economic determinants of health. These include income and social status, social support networks, education and literacy (including but not limited to health literacy), employment and working conditions, social environments, physical environments, life skills, personal health practices and coping skills, healthy child development, biology and genetic endowment, health services, gender, culture, among others.

In Africa, poverty, unemployment and homelessness continue to hamper development with almost 50% of Africans living in extreme poverty. In Kenya, for example, 56% of the people live under the poverty line. Inequalities are also a big problem, with a small percentage of the population controlling the majority of the wealth.

In 2009, the WHO Commission on Social Determinants of Health published a report clarifying SDH and the processes that influence the health and well-being of populations and providing recommendations to reduce health inequities.

For more information on SDH, please go to:

 

Policy, Legislation and Environmental Change

Effective policy making to tackle health challenges must address underlying social conditions that make disadvantaged people more vulnerable. Ministries of Health cannot address such health challenges alone but can take the leadership in advancing actions/policy on SDH across government departments and the wider society.

 

Some useful resources can be found at various National Ministries in each country.

 

Course outcome

Since 2004, over 160 professionals from 6 countries in sub-Saharan Africa (Gambia, Ghana, Kenya, Nigeria, Tanzania and Uganda) and from multi-disciplinary backgrounds (such as nutrition, community nurses, media, policy/decision- makers, physicians, health promoters, public health professionals, social scientists, physical activity professionals, etc.) have been trained.

 

Executive Summary of Recent Courses

The 2008 and 2009 CDC/IUHPE Annual Seminars on Cardiovascular Health Promotion and Chronic Disease Epidemiology have been summarized. Executive Summaries of the courses and parallel meetings are now available:

 

Lessons learnt and Recommendations

The first four Annual Seminars have been independently evaluated. This evaluation was conducted to share knowledge, experiences, lessons learnt, and good practice examples; to inform future work and better achieve the objectives of the seminars as well as to ensure these are disseminated within the region and more broadly.

The members of the faculty of the CDC/IUHPE Annual Seminars on Cardiovascular Health Promotion and Education have actively addressed the recommendations from the independent evaluation report to inform improved process and delivery of the 6th CDC/IUHPE Annual Seminar. Please refer to the Executive Summary for more details on how the recommendations were addressed.

 

Abstracts, Progress and Results of team projects developed during the seminars

Each year, the country teams developed projects based on teachings and group work during the training seminars. The projects were developed with the following considerations in mind:

  • Make it local: The projects should be adapted to the communities you know best. Be creative in thinking about how to implement the most effective and potentially sustainable interventions.

  • Focus on community health development: Our goal is to advance health promotion at the population or community level. Of course, we are also concerned about individuals who already have CVD, however that is not the focus of this programme.

  • Make it feasible: It is very tempting to propose a large, comprehensive project. At this stage, however, it is important to take on something that can be accomplished within current available resources, which should be carefully assessed while projects are being planned.

  • Evaluate whatever you do: Cardiovascular disease prevention in Africa is at an early stage and we have much to learn. We must remember that each of these efforts is an important opportunity to learn more and improve our chances of success in the long term.

 

Project proposals include:

  • An abstract;

  • A problem statement and a brief review of current knowledge attached to such problems;

  • A statement of the specific goals;

  • A description of the plan for the intervention and timeline; An evaluation plan; and

  • A budget.

 

Examples of what has or is currently being done in the region will soon be available for the following countries:

  • The Gambia;

  • Ghana;

  • Nigeria;

  • Kenya;

  • Tanzania;

  • Uganda;

 

Partners and links