Participating institutions

Institute of Nutrition of Central America and Panama (INCAP)

Ministry of Health and Social Assistance  (MSPAS)

Liverpool School of Tropical Medicine

National Program for the Prevention of Non communicable Diseases and Cancer

Center of Research for Equity and Governance on Health Systems (CEGSS)

CIIPEC Researchers

Manuel Ramírez-Zea

David Flood

Guillermo Hegel Alcara

Alicia Wellman Castellanos 

Maria Fernanda Ayau

Jose Javier Rodríguez

Summary 

Guatemala has the highest burden of cardiovascular disease (CVD) in Central America. The hypertension prevalence in rural Guatemala is approximately 20%, but treatment is largely unavailable. We plan to adress this gap by demostrating that community-based, patient-centered strategies (social accountability interventions, municipal pharmacies, and digital task sharing tools) to improve blood pressure (BP) control can be sustainably implemented in rural Guatemala (3 municipalities, department of Solola). The development, monitoring and evaluation of the proposed strategies will be guided by the HEARTS "System of Monitoring" guide and the, RE-AIM QuEst (Reach, efficacy, adoption, implementation and maintenance qualitative evaluation for systematic translation) mixed-methodos implementation framework. This proposal will be tightly integrated into the public health system and local municipalities. The project will leverage our team´s ongoing hypertension program conducted jointly with the Ministry of Health (MOH) that adapts 6 HEARTS-aligned strategies to over 100 health facilities in rural Guatemala. 

Objectives

The overall goals of the program are:

1. Assess the proportion of participants with non controlled hypertension that are able to control their blood pressure (defined as <130/80 mmHg) after 6 months of follow-up.

2. Assess the patient´s adherence to medication.

3. Assess the knowledge of the health care provider and patients who participate on the self care groups. 

Methodology 

Financing 

Project duration

This project will be carried out closely to the public health system and the local municipalities. Each of the participants will be exposed to a six months intervention. The intervention is a multicomponent program that was used on a previous project (HyTrec), which includes a hypertension treatment based on a protocol and five strategies of implementation. This intervention will be carried out by the staff at the health posts and health centers of the Ministry of Health and Social Assistance. Besides, the intervention will also be supported by three community-based and patient-centered strategies to improve blood pressure control. 

LINKS, through Vital Strategies. 

May 2021-November 2022