Fellow’s research: Engaging non-physician health workers in blood pressure management in low income and middle income countries


27 May 2019

Fellow’s research: Engaging non-physician health workers in blood pressure management in low income and middle income countries

 

Dr Jeemon Panniyammakal

Intermediate Fellow, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum

In a recent study, we evaluated the possibility of involving non-physician health workers for non-communicable disease prevention and management in resource poor settings and demonstrated that task sharing with non-physician health workers is an effective strategy in reducing population average blood pressure.

We systematically identified evidence from well-conducted experimental studies in low and middle-income country settings and pooled outcome data on blood pressure reduction. We observed a gradient in population average blood pressure reduction with doctor-population ratio; higher the ratio better the results. Additionally, compared to community health-worker led interventions, interventions led by nurse, pharmacist or dietician were found to be more effective in reducing average blood pressure.

Consequently, we concluded that task-sharing interventions are effective in reducing blood pressure. However, long-term studies are needed to understand their potential impact on cardiovascular outcomes and mortality. Nevertheless, involving non-physician health-care workers in blood pressure control is an effective option in low-income and lower-middle income countries.

Track your numbers (blood pressure) and maintain it at the optimal level (Mrs. Sheeja Thankaraj, ASHA, shot at Balaramapuram, Kerala, India with permission).

References:

Task sharing with non-physician health-care workers for management of blood pressure in low-income and middle-income countries: a systematic review and meta-analysis. T N Anand, Linju Maria Joseph, A V Geetha, Dorairaj Prabhakaran, Panniyammakal Jeemon. The Lancet Global Health, June 2019.

Banner Image Credits: Clinic staff members see patients enrolled in the hypertension program. © 2017 Tribal Health Initiative (http://www.ghspjournal.org/content/5/4/668).