Cardiovascular disease: combining research and action
Over 700 people living in Korogocho and Viwandani slums in Nairobi, Kenya have benefited from free drugs, regular screening and check-ups for heart disease, hypertension and other chronic conditions. Not what you might expect from a research institute, but this is how the African Population and Health Research Center (APHRC) is combining research and action. Elizabeth Kahurani and Rose Oronje tell the story.
The African Population and Health Research Center (APHRC) is spearheading efforts to ease the growing burden of chronic disease, especially among the urban poor. “Diseases that affect the heart and the blood circulation system, also known as cardiovascular diseases (CVD), are a leading cause of death and ill health in sub-Saharan Africa among adults aged 30 years and above,” said Dr Catherine Kyobutungi, an Associate Research Scientist at APHRC.
Projections from WHO’s Global Burden of Disease indicate that from 1990 to 2020, the burden of CVD faced by African countries will double. The increase in the number of people diagnosed with CVD is alarming. Africa’s weak health systems, which are already collapsing under the yoke of infectious diseases, now have to contend with this glaring epidemic.
“Our health systems are ill prepared to handle the increasing burden of chronic diseases, mainly due to lack of data and poor health information systems,” explained Dr Kyobutungi, underscoring the need for research. Early diagnosis of these conditions could help prevent complications and prolong life. Regular screening could help individuals lead healthier lives as they will have more access to better information and be able to make different choices.
These diseases greatly affect the quality of life of individuals who have them. They are chronic and expensive to manage and they often strain the resources of families. In urban slums, the high stress environment, risky behaviours and limited access to health care mean poor marginalised populations in these slums are adversely affected. For this reason APHRC is combining research and action. APHRC is collaborating with the City Council of Nairobi, Provide International and The Kenya Diabetes Management and Information Center to provide free medical services to residents of Korogocho and Viwandani slums in Nairobi, Kenya. Over 700 people in these two communities have now benefited from free drugs, regular screening/check-ups, counselling and other services offered at the CVD medical clinics.
Before the project started, many of the beneficiaries carried out their day-to-day routines unaware that they suffered from diabetes or hypertension. When some people experienced constant headaches or fatigue, they thought it was normal. “I often would feel fatigued even without having engaged in any chores,” said Beatrice Wakeeni, who was among the first people to be screened. “I got a visit from two of APHRC’s field staff who I allowed to conduct a hypertension and diabetes screening. After the procedure, one of them paused and politely asked me, ‘Cucu (grandmother), have you been thinking a lot lately?’ Then they slowly explained that I was hypertensive.” The same story goes for 48-year-old John Mburu, who experienced frequent headaches but did not think that it was anything serious. When he was screened, he discovered that he had hypertension.
Previously, no-one informed the slum population of the need for regular screening. Even if they had been informed, the fee charged for screening is way beyond their means. The majority of the population survives on under a dollar a day and many take care of large families. “All of us here thank APHRC for bringing these health services close to us. Many people here suffer and die because they even do not know where to go for help,” John Mburu said.
The clinics are part of a wider research project whose main objective is to assess CVD risk factors and risk perception among the adult population in Nairobi slums. For a long time, CVD have been associated with the rich as a lifestyle disease, but current trends are proving otherwise. This research study will examine linkages between socio-economic and socio-cultural factors, as well as health behaviour that put the urban poor at risk. If taken up, this evidence-based information will no doubt inform strategies for developing sustainable health systems and other interventions that target this population effectively.
Being an international research organisation, APHRC has over the years continued to generate credible scientific evidence with an aim to promote the wellbeing of Africans through policy relevant research on population and health. The organisation runs a continuous survey that monitors households within the Korogocho and Viwandani slum areas on a regular basis. Data from this survey serves to inform policies and programmes that aim to address the challenges of an ever growing urban population, particularly now in the context of a huge economic downturn. Besides health, APHRC has conducted further research on education, poverty, and sexual and reproductive health and continues to engage actively and work with policy makers as well as other key stakeholders who use this research to bring about the much needed change.
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