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The HEARTS technical package provides a strategic approach to improving cardiovascular health in countries. It comprises six modules and an implementation guide. This package supports Ministries of Health to strengthen CVD management in primary health care settings. The practical, step-by step modul
...
es are supported by an overarching technical document that provides a rationale and framework for this integrated approach to the management of NCDs.
more
In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles
...
terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
more
Procurement and supply management activities are fundamental to consistent and reliable access to essential medicines and health products. To reduce the impact of CVD, action needs to be taken to improve prevention, diagnosis, care and management of CVD diseases. Affordable essential medicines and t
...
echnologies to manage CVD disease must be available where and when they are required. Medicines and technologies need to be managed appropriately to ensure that the correct medicines are selected, procured in the right quantities, distributed to facilities in a timely manner, and handled and stored in a way that maintains their quality. This needs to be backed up by policies that enable sufficient quantities to be procured in order to reduce cost inefficiencies, ensure the reliability and security of the distribution system, and encourage the appropriate use of these health products. In order to avoid stock-outs and the disruption of treatment, all related activities need to be conducted in a timely manner, with performance continually monitored, and prompt action taken in response to problems that may arise. Additionally, medication must be dispensed correctly and used rationally by the healthcare provider and patient alike. The purpose of this guide is to explain the necessary steps.
more
Many low-resource settings have a shortage of physicians and health workers. (1) In order to provide patient-centred continuous care more effectively, primary care systems can include team-based care strategies in their clinic workflows and protocols. Team-based care uses multidisciplinary teams (wh
...
ich may involve new staff, or the shifting of tasks among existing staff). Teams can include patients themselves, primary care physicians, and other allied health professionals, such as nurses, pharmacists, counsellors, social workers, nutritionists, community health workers, or others. Teams reduce the burden on physicians by utilizing the skills of trained health workers. Strong evidence shows that team-based care is effective in improving hypertension control among patients in a cost-effective way. (2) Some amount of task shifting/team-based care is already taking place in many settings; this module provides further guidance on how to maximize this approach for greater impact.
more
HEARTS provides a set of locally adaptable tools for strengthening the
management of CVD in primary health care.
HEARTS is designed to enhance implementation of WHO PEN by providing:
• operational guidance on further integrating CVD management
• technical guidance on evaluating the impact of
...
CVD care on patient outcomes.
For countries not using WHO PEN, CVD management can still be integrated into
primary health care. The process of implementing HEARTS will vary, depending
on country context, and may require a significant reorienting and strengthening
of the health system. At some sites, existing CVD management services may be
reoriented toward a risk-based approach, while other sites may adopt a public
health approach, strengthening management of particular risk factors such as
hypertension. Whether or not introducing CVD management into primary care is a
new intervention, successful implementation will require engagement with national and local health planners, managers, service providers, and other stakeholders.
more
A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
AHA/ASA Guideline
DOI: 10.1161/STR.0000000000000158
Guidance for orphans and vulnerable children programming
PEPFAR
(2012)
C2
The U.S. President‘s Emergency Plan for AIDS Relief
PLOS ONE | https://doi.org/10.1371/journal.pone.0217693 June 7, 2019
PMTCT private sector engagement
SAATHII (Solidarity and Action Against The HIV Infection in India); Elizabeth Glaser Pediatric AIDS Foundation
(2019)
C2
Accessed: 30.10.2019
A “catastrophic” combination of drought and communities’ declining resilience has left an estimated 2.3 million people facing severe acute food insecurity – up from an estimate of 1.7 million people a month ago.
Communities across southern Africa have been affected by drought since late 2
...
018.
This year, large parts of southern and western Zambia received their lowest seasonal rainfall totals since at least 1981, the base year from which normal rainfall is benchmarked. At the same time, northern and eastern parts of the country were affected by flash floods and waterlogging, resulting in poor harvests.
more
The DHS report itself explains the purpose was, “to obtain and provide information on basic indicators of social progress including fertility, childhood mortality, reproductive and child health, nutritional status of children, and awareness of HIV/AIDS and other health-related issues” in PNG. Th
...
is is important because a DHS then provides the evidence base for PNG officials themselves to track progress in PNG over time, compare trends with other comparable countries, and then allocate financial and human resources to where they are needed most.
more
The Cholera Q&A Fact Sheet provides essential information about cholera, including its causes, symptoms, treatment, and prevention. Cholera is an acute diarrheal disease caused by Vibrio cholerae, which spreads through contaminated water and food. It leads to rapid dehydration and can be fatal if un
...
treated. Symptoms range from mild diarrhea to severe dehydration, shock, and death.
Treatment primarily involves Oral Rehydration Therapy (ORT) to replace lost fluids, and in severe cases, intravenous fluids. Antibiotics are generally not recommended for mass treatment. Prevention focuses on safe drinking water, sanitation, hand hygiene, and proper food handling.
The document also discusses cholera vaccination, with three WHO-approved oral vaccines available. However, vaccines should be used alongside other control measures. The Global Task Force on Cholera Control (GTFCC) aims to eliminate cholera transmission in 20 countries by 2030 through improved sanitation, vaccination, and rapid outbreak response.
more
