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Engaging the Entire Care Cascade in Western Kenya: A Model to Achieve the Cardiovascular Disease Secondary Prevention Roadmap Goals.

Publication ,  Journal Article
Vedanthan, R; Kamano, JH; Bloomfield, GS; Manji, I; Pastakia, S; Kimaiyo, SN
Published in: Glob Heart
December 2015

Cardiovascular disease (CVD) is the leading cause of death in the world, with a substantial health and economic burden confronted by low- and middle-income countries. In low-income countries such as Kenya, there exists a double burden of communicable and noncommunicable diseases, and the CVD profile includes many nonatherosclerotic entities. Socio-politico-economic realities present challenges to CVD prevention in Kenya, including poverty, low national spending on health, significant out-of-pocket health expenditures, and limited outpatient health insurance. In addition, the health infrastructure is characterized by insufficient human resources for health, medication stock-outs, and lack of facilities and equipment. Within this socio-politico-economic reality, contextually appropriate programs for CVD prevention need to be developed. We describe our experience from western Kenya, where we have engaged the entire care cascade across all levels of the health system, in order to improve access to high-quality, comprehensive, coordinated, and sustainable care for CVD and CVD risk factors. We report on several initiatives: 1) population-wide screening for hypertension and diabetes; 2) engagement of community resources and governance structures; 3) geographic decentralization of care services; 4) task redistribution to more efficiently use of available human resources for health; 5) ensuring a consistent supply of essential medicines; 6) improving physical infrastructure of rural health facilities; 7) developing an integrated health record; and 8) mobile health (mHealth) initiatives to provide clinical decision support and record-keeping functions. Although several challenges remain, there currently exists a critical window of opportunity to establish systems of care and prevention that can alter the trajectory of CVD in low-resource settings.

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Published In

Glob Heart

DOI

EISSN

2211-8179

Publication Date

December 2015

Volume

10

Issue

4

Start / End Page

313 / 317

Location

England

Related Subject Headings

  • Secondary Prevention
  • Medically Underserved Area
  • Kenya
  • Humans
  • Health Services Accessibility
  • Goals
  • Delivery of Health Care
  • Cost of Illness
  • Cardiovascular Diseases
  • Ambulatory Care
 

Citation

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ICMJE
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Vedanthan, R., Kamano, J. H., Bloomfield, G. S., Manji, I., Pastakia, S., & Kimaiyo, S. N. (2015). Engaging the Entire Care Cascade in Western Kenya: A Model to Achieve the Cardiovascular Disease Secondary Prevention Roadmap Goals. Glob Heart, 10(4), 313–317. https://doi.org/10.1016/j.gheart.2015.09.003
Vedanthan, Rajesh, Jemima H. Kamano, Gerald S. Bloomfield, Imran Manji, Sonak Pastakia, and Sylvester N. Kimaiyo. “Engaging the Entire Care Cascade in Western Kenya: A Model to Achieve the Cardiovascular Disease Secondary Prevention Roadmap Goals.Glob Heart 10, no. 4 (December 2015): 313–17. https://doi.org/10.1016/j.gheart.2015.09.003.
Vedanthan R, Kamano JH, Bloomfield GS, Manji I, Pastakia S, Kimaiyo SN. Engaging the Entire Care Cascade in Western Kenya: A Model to Achieve the Cardiovascular Disease Secondary Prevention Roadmap Goals. Glob Heart. 2015 Dec;10(4):313–7.
Vedanthan, Rajesh, et al. “Engaging the Entire Care Cascade in Western Kenya: A Model to Achieve the Cardiovascular Disease Secondary Prevention Roadmap Goals.Glob Heart, vol. 10, no. 4, Dec. 2015, pp. 313–17. Pubmed, doi:10.1016/j.gheart.2015.09.003.
Vedanthan R, Kamano JH, Bloomfield GS, Manji I, Pastakia S, Kimaiyo SN. Engaging the Entire Care Cascade in Western Kenya: A Model to Achieve the Cardiovascular Disease Secondary Prevention Roadmap Goals. Glob Heart. 2015 Dec;10(4):313–317.
Journal cover image

Published In

Glob Heart

DOI

EISSN

2211-8179

Publication Date

December 2015

Volume

10

Issue

4

Start / End Page

313 / 317

Location

England

Related Subject Headings

  • Secondary Prevention
  • Medically Underserved Area
  • Kenya
  • Humans
  • Health Services Accessibility
  • Goals
  • Delivery of Health Care
  • Cost of Illness
  • Cardiovascular Diseases
  • Ambulatory Care