By Samwel Doe Ouma @samweldoe
Ministry of Health (MoH), Kenya Cardiac Society (KCS), World Heart Federation (WHF) and AstraZeneca’s -Healthy Heart Africa (HHA) program- among other stakeholders have called for more collaborative action to address gaps in building sustainable and equitable access to care for people living with cardiovascular diseases like stroke.
Speaking at a roundtable meeting in Nairobi ‘titled building effective and sustainable health systems for hypertension and CVD care in Kenya’ to commemorate World Stroke Day, Dr Elizabeth Onyango said that among the Non-Communicable Diseases (NCDs), cardiovascular diseases have stood out as a significant threat with world health organization (WHO) ranking them as number one global cause of mortality.
“Stroke is most critical contributor to cardiovascular diseases with at least 3.5 percent of Kenyan citizen suffering from a symptomatic cardiovascular disease which is more likely to be detected at an advanced stage when complications such as stroke a rise.” Dr Elizabeth said.
According to Ministry of health, government aims to strengthen primary health care to provide preventive care, early referral and nutrition and wellness.
“We have revised non communicable diseases tools and in the process of finalizing community screening tools for hypertension and DM (key risk factors for stroke),” Dr Elizabeth said.
She said that hypertension is the single biggest contributor to stroke, however, according to ministry of health STEPS survey only 22.3 percent of those diagnosed were on treatment and only three percent had their blood pressure.
The STEPs survey also revealed an upward trend in cardiovascular diseases burden with hypertension, unhealthy diet, obesity, excessive weight, and physical inactivity cited as major contributors.
According to Ministry of health data, strokes accounts for 6.1 percent of total deaths in Kenya and leading Cardiovascular related contributor to mortalities.
The stake holders drawn from different sectors including public and private sectors, academia, patient led organizations, civil societies, and healthcare professionals pointed out that despite great strides that have been made in bridging health systems strengthening initiatives, there still exists gaps that require multi-stakeholders’ engagement and call for action.
While Ashling Mulvaney, vice president Global Sustainability and Access to healthcare at AstraZeneca said that successful partnerships created through Healthy Heart Africa (HHA) program show that it is possible to provide sustainable solutions to resilience of local health systems.
“Our partnerships with public and private healthcare facilities are helping to integrate blood pressure screening and hypertension management into routine care,” Ashling said adding that “In Kenya the program has so far conducted over 17.4 million blood pressure screening, 3.3 million elevated blood pressure readings, with over 806,000 of these being confirmed for diagnoses for hypertension.”
HHA also provides health systems strengthening by training healthcare workers on the diagnosis and management of CVDs. The program is being implemented in nine countries in Africa which is Kenya, Rwanda, Ethiopia, Tanzania including Zanzibar, Ghana, Uganda, Cote d’ivoire, Senegal and Nigeria.
According to Dr Bernard Samia President Kenya cardiac Society 60 percent of stroke patients acquire permanent disability and experience limitations in terms of speech, voice, swallowing, mobility, vision, and sexual function.
Kenya Cardiac society is urging healthcare providers especially public hospitals to set up rehabilitative care to stroke patients.
He adds that, various levels of government hospitals lack established stroke units. “Most public hospitals are encouraged to have stroke rehabilitative centers with basic things such as physiotherapy, speech therapists and occupational therapists and support groups.”
However, management of stroke once it occurs is usually very complex, Dr Samia said adding that, “most Stroke patients face difficulties in performing basic functional activities such as walking and feeding using the affected hand resulting in dependence of caregivers for basic self-care and daily activities.”
There is an urgent need to initiate rehabilitative care to address functional and limitations that can facilitate stroke survivors return to work. Affordability of rehabilitative stroke services is out of reach to many patients. Insurance services do not cover rehabilitative services. Most of stroke survivors are left on their own.
“Most stroke survivors are over- burdened by financial limitations not only as a result of reduced income since they cannot return to their previous occupation due to their conditions which limits them in terms of activity and day to day participation, but also national health Insurance fund (NHIF) do not cover stroke rehabilitative services.”
The event was attended by speakers from World Heart Federation (WHF), Stroke Association of Kenya (SAOK), a patient led organization, Neurology Society of Kenya, Non-Communicable Diseases Alliance of Kenya (NCD-AK), representing the civil society.
Various speakers identified action plans for the various stakeholders and highlighted awareness and prevention as key strategies for improved cardiovascular care in Kenya.
