Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 May 17:11:325.
doi: 10.1186/1471-2458-11-325.

Implementing a hypertension management programme in a rural area: local approaches and experiences from Ba-Vi district, Vietnam

Quang Ngoc Nguyen  1 , Son Thai Pham, Viet Lan Nguyen, Stig Wall, Lars Weinehall, Ruth Bonita, Peter Byass
Affiliations

Implementing a hypertension management programme in a rural area: local approaches and experiences from Ba-Vi district, Vietnam

Quang Ngoc Nguyen et al. BMC Public Health. .

Abstract

Background: Costly efforts have been invested to control and prevent cardiovascular diseases (CVD) and their risk factors but the ideal solutions for low resource settings remain unclear. This paper aims at summarising our approaches to implementing a programme on hypertension management in a rural commune of Vietnam.

Methods: In a rural commune, a programme has been implemented since 2006 to manage hypertensive people at the commune health station and to deliver health education on CVD risk factors to the entire community. An initial cross-sectional survey was used to screen for hypertensives who might enter the management programme. During 17 months of implementation, other people with hypertension were also followed up and treated. Data were collected from all individual medical records, including demographic factors, behavioural CVD risk factors, blood pressure levels, and number of check-ups. These data were analysed to identify factors relating to adherence to the management programme.

Results: Both top-down and bottom-up approaches were applied to implement a hypertension management programme. The programme was able to run independently at the commune health station after 17 months. During the implementation phase, 497 people were followed up with an overall regular follow-up of 65.6% and a dropout of 14.3%. Severity of hypertension and effectiveness of treatment were the main factors influencing the decision of people to adhere to the management programme, while being female, having several behavioural CVD risk factors or a history of chronic disease were the predictors for deviating from the programme.

Conclusion: Our model showed the feasibility, applicability and future potential of a community-based model of comprehensive hypertension care in a low resource context using both top-down and bottom-up approaches to engage all involved partners. This success also highlighted the important roles of both local authorities and a cardiac care network, led by an outstanding cardiac referral centre.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Process to set up and develop a programme on hypertension management in adults at commune-level.
Figure 2
Figure 2
Rate of newcomer recruitment into the hypertension management programme during 17 months of the implementation phase.
See this image and copyright information in PMC

References

    1. Mackay J, Mensah GA. The atlas of heart disease and stroke. Geneva, Switzerland: World Health Organization; 2004.
    1. The World Health Report 2003: Shaping the future. World Health Organization; 2003.
    1. Parker DR, Assaf AR. Community interventions for cardiovascular disease. Prim Care Clin Office Pract. 2005;32(4):865–881. doi: 10.1016/j.pop.2005.09.012. - DOI - PubMed
    1. Sellers DE, Crawford SL, Bullock K, McKinlay JB. Understanding the variability in the effectiveness of community heart health programs: a meta-analysis. Soc Sci Med. 1997;44(9):1325–1339. doi: 10.1016/S0277-9536(96)00263-8. - DOI - PubMed
    1. Brännström I, Weinehall L, Persson LA, Wester PO, Wall S. Changing social patterns of risk factors for cardiovascular disease in a Swedish community intervention programme. Int J Epidemiol. 1993;22(6):1026–1037. doi: 10.1093/ije/22.6.1026. - DOI - PubMed

Publication types