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
. 2013 Oct 21:6:22510.
doi: 10.3402/gha.v6i0.22510.

Introducing a model of cardiovascular prevention in Nairobi's slums by integrating a public health and private-sector approach: the SCALE-UP study

Steven van de Vijver  1 , Samuel Oti, Thijs Cohen Tervaert, Catherine Hankins, Catherine Kyobutungi, Gabriela B Gomez, Lizzy Brewster, Charles Agyemang, Joep Lange
Affiliations

Introducing a model of cardiovascular prevention in Nairobi's slums by integrating a public health and private-sector approach: the SCALE-UP study

Steven van de Vijver et al. Glob Health Action. .

Abstract

Introduction: Cardiovascular disease (CVD) is a leading cause of death in sub-Saharan Africa (SSA), with annual deaths expected to increase to 2 million by 2030. Currently, most national health systems in SSA are not adequately prepared for this epidemic. This is especially so in slum settlements where access to formal healthcare and resources is limited.

Objective: To develop and introduce a model of cardiovascular prevention in the slums of Nairobi by integrating public health and private sector approaches.

Study design: Two non-profit organizations that conduct public health research, Amsterdam Institute for Global Health and Development (AIGHD) and African Population and Health Research Center (APHRC), collaborated with private-sector Boston Consulting Group (BCG) to develop a service delivery package for CVD prevention in slum settings. A theoretic model was designed based on the integration of public and private sector approaches with the focus on costs and feasibility.

Results: The final model includes components that aim to improve community awareness, a home-based screening service, patient and provider incentives to seek and deliver treatment specifically for hypertension, and adherence support. The expected outcomes projected by this model could prove potentially cost effective and affordable (1 USD/person/year). The model is currently being implemented in a Nairobi slum and is closely followed by key stakeholders in Kenya including the Ministry of Health, the World Health Organization (WHO), and leading non-governmental organizations (NGOs).

Conclusion: Through the collaboration of public health and private sectors, a theoretically cost-effective model was developed for the prevention of CVD and is currently being implemented in the slums of Nairobi. If results are in line with the theoretical projections and first impressions on the ground, scale-up of the service delivery package could be planned in other poor urban areas in Kenya by relevant policymakers and NGOs.

Keywords: Africa; cardiovascular diseases; health system; hypertension; prevention; slums.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Cascade of care for hypertension and CVD risk reduction.
Fig. 2
Fig. 2
Components of the final service delivery package.
Fig. 3
Fig. 3
Potential cost calculations of the final service delivery package.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012;380:2095–128. - PMC - PubMed
    1. World Health Organization (WHO) WHO Press; 2008. Global burden of disease [Internet] Available from: http://www.who.int/healthinfo/global_burden_disease/ [cited 15 March 2012].
    1. Godfrey R, Julien M. Urbanisation and health. Clin Med. 2005;5:137–41. - PMC - PubMed
    1. Addo J, Smeeth L, Leon DA. Hypertension in sub-Saharan Africa: a systematic review. Hypertension. 2007;50:1012–18. doi: 10.1161/HYPERTENSIONAHA.107.093336. - DOI - PubMed
    1. UN-Habitat. Nairobi: UN-Habitat; 2010. The state of African cities 2010: governance, inequalities and urban land markets.

Publication types

MeSH terms

LinkOut - more resources