WHO ON BURKINA FASO

In Burkina Faso, around 1.5 million people have or are at high risk of heart disease.
Cardiovascular disease (CVD) is responsible for around one-in-three deaths – approximately
20 600 each year – and more than from any other NCD.
One-in-three adults in the country are also estimated to be living with raised blood pressure
(also known as ‘hypertension’). But despite hypertension being common among the
population, only around 30% of people living with the condition receive treatment for it, of
whom less than half have their condition under control.
Burkina Faso 60 Second Read Credit: WHO
Facing up to NCDs
Burkina Faso’s Ministry of Health has been proactive in tackling the sizeable burden of NCDs
to its health system, and has created a directorate dedicated to work on preventing and
controlling NCDs. In addition to an integrated strategic plan on NCDs, several national
strategies have been launched, including actions on cancer, eye and oral health, mental
illness and tobacco control.
However, several challenges to good heart health persist, including the lack of standardised
medical protocols, patchy access to basic equipment, essential medicines and consumables
needed to diagnose and manage hypertension in primary health facilities.
For Dr Arthur Seghda, a cardiologist at Centre Hospitalized Universitario de Ogopogo,
building health worker skills is absolutely vital:
Burkina Faso Quote 1
Credit: WHO
Building the tools to tackle hypertension
Integrating NCD management into existing health services is critical for patients across
Burkina Faso to receive the quality of care they deserve. However, doing so requires the
right policies, guidance and training, designed in the context of local health systems. These
tools can enable health workers to act on hypertension and other NCDs with confidence.
Although millions of people live with hypertension in Burkina Faso, context-specific training
on the condition is not available for health care workers at the local level. For example, few
health workers have adequate equipment to monitor people living with hypertension.
In addition, primary health care centres do not routinely assess for CVD risk – a process
needed to identify those most vulnerable and tailor treatment – in part because practical
guidelines for screening, diagnosing and treating heart conditions are lacking.
This lack of strategic planning for NCDs, coupled with high prevalence of hypertension
across the country, is a cause for concern. If health care staff cannot access specific
equipment and guidance to manage hypertension, it could have serious consequences for
health outcomes and patient care.
Fixing these challenges Although WHO has created a global technical package to help
manage cardiovascular diseases, it is necessary to work with countries to adapt this package
to local health system contexts.
Against this background, Burkina Faso’s Ministry of Health in conjunction with other key
partners, such as the Burkinabè Society for Cardiology, the Burkinabe Society of Internal
Medicine and patient associations, recently set up a project to:
Create a context-specific training manual for health care staff to diagnose, treat and manage
hypertension.
Train health workers in urban and rural settings to use the new tools, and equip them with
the kit needed to effectively do so.
The Kombissiri Health District, located in the Bazèga province in the Center-Sud region of
Burkina Faso, was chosen as the pilot site. Kombissiri was a vital place to pilot the project,
with almost two thirds of outpatient consultations at the district hospital being for either
hypertension or diabetes.
Dr Compaoré W.A. Sandrine, a physician in the Kombissiri Health District, believes the use of
new tools and training in the district’s health and social promotion centers will help improve
care for the local community:
Burkina Faso Quote 2
Credit: WHO
The result: improved awareness and understanding of how to manage hypertension
Over just a few short months, considerable progress has been made. A new protocol and
training manual for the management of hypertension were developed for health care
workers.
Thirty-two health care workers across the Kombissiri Health District, including head nurses,
midwives and maieuticians, have been trained in these new tools. This training will help give
them the building blocks to embed hypertension management in their health systems.
Burkina Faso 32 image
Credit: WHO
However, using this guidance also relies on having the right equipment to do so. As such,
the team worked with 10 local primary health clinics across the Kombissiri Health District,
providing them with blood pressure monitors, blood glucose meters, weighing scales and
tape measures.
According to Dr Marie Emmanuelle Zouré, Director of Prevention and Control of NCDs,
Ministry of Health, the pilot project is a real opportunity for Burkina Faso:
Burkina Faso Quote 3
Credit: WHO
The next step: what happens now?
As Dr Zoure hopes, work will now be undertaken to further strengthen and standardize
hypertension care across primary health services, including scaling care to other health
districts. This will include setting up data collection systems on capture data on NCD
management in primary care.
Finally, to make sure the tools and training remain helpful and effective, the team will
continue to work with those 32 nurses and midwives, to learn from their experiences.
Across the Global Week for Action on NCDs (7–13 September 2020), we are sharing stories
from the field about why acting on NCDs is so important. These stories have emerged from a
recent project funded by the Government of Denmark. Today's story was written by
Professor Jean-Marie Dangou and Mr Daniel Hunt. The authors give their acknowledgement
and thanks to Dr Marie Emmanuelle Zouré, Dr Arthur Seghda and Dr Sandrine W.A.
Compaoré.