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Innovative practice

ComHIP enables patients to access diagnosis and care at community level in Ghana

What:

To improve the control of hypertension, by making services more accessible, and empowering individuals to manage their hypertension.

Model:

Public-private partnership that embeds services for hypertension control and self-management in local communities via ‘local private medicinal’ shops.

Partners:

Novartis Foundation, Ghana Health Service and US-based development organisation FHI 360, supported by the Ghana School of Public Health, the London School of Hygiene & Tropical Medicine, and VOTO Mobile, a Ghana-based social enterprise.

Scale-up:

To three districts in Ghana, from two in 2016.

In 2015, the Novartis Foundation – part of Novartis’s philanthropic organisation established an initiative in Ghana to test an innovative healthcare model for the control and self-management of hypertension. As a major risk factor for cardiovascular diseases, hypertension affects as many as 36% of Ghana’s adults. While awareness of the condition has increased, control of hypertension remains poor.

How does this model improve access to hypertension care?
The Community-based Hypertension Improvement Project (ComHIP) set out to test the benefits of enabling patients to access diagnosis and care at community level through local healthcare workers and businesses, rather than at hospitals, which can be distant and overcrowded. The test included comparing conventional methods of hypertension care (where hypertension care is coordinated among primary healthcare providers and pharmacists, along with specialists if needed), with an innovative approach. The approaches were tested in two districts close to urban centres in Ghana.

Novartis's ComHIP works with private medicinal shops to offer blood pressure screenings. ©Novartis Foundation

The innovative approach worked with local private medicinal shops (often a first stop for healthcare locally) to offer blood pressure screening, and to dispense medicines. With around 20 shops for every hospital, the aim was to maximise convenience and increase opportunities for diagnosis. This district also facilitated the use of digital health tools: by health workers to help make decisions and ensure connections; and by patients to manage progress and keep track of appointments.

How has this business model been scaled up?
In April 2017, a team from LSHTM FHI 360 published an evaluation of ComHIP’s model, based on the responses of some 2,400 people. With support from Novartis and other partners, Ghana Health Service is now taking the lead to expand the model; it is rolling out ComHIP in a third district in Ghana, while continuing to operate the model in the original two districts. The design of this intervention implementation study and subsequent publication of the ComHIP evaluation paper demonstrates a commitment to implementing programmes using a sound evidence base.

The Novartis Foundation also has a second innovative healthcare model for hypertension in Vietnam, through its Ho Chi Minh City Communities for Healthy Hearts Program since 2016.


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