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. 2024 Oct 24;25(1):382.
doi: 10.1186/s12875-024-02620-0.

Hypertension and diabetes control: faith-based centres offer a promise for expanding screening services and linkage to care in Ghana

Engelbert A Nonterah  1   2   3 , Samuel T Chatio  4   5 , Andy Willis  6 , Joseph A Alale  4 , Sawudatu Zakariah-Akoto  7 , Natalie Darko  8 , Ffion Curtis  9 , Setor K Kunutsor  10 , Ceri Jones  11 , Samuel Seidu  8   9 , Patrick O Ansah  4   5
Affiliations

Hypertension and diabetes control: faith-based centres offer a promise for expanding screening services and linkage to care in Ghana

Engelbert A Nonterah et al. BMC Prim Care. .

Abstract

Background: Hypertension and type 2 diabetes mellitus (T2DM) are important contributors to noncommunicable disease related morbidity and mortality. Health systems could benefit from exploring the use of Faith-Based Centres (FBC) to screen and link suspected cases for further care in order to help achieve Sustainable Development Goal (SDG) 3. The study investigated the role of faith-based screening for T2DM and hypertension and the linkage of cases to the healthcare system and examined the care cascade in the Kassena Nankana Districts of Northern Ghana.

Methods: We screened individuals from 6 FBCs for elevated blood pressure and hyperglycaemia. Suspected hypertension and T2DM cases were referred to health facilities for confirmation and subsequently followed them up for 3 months. We assessed the prevalence of behavioural and metabolic risk factors, including hypertension and T2DM, and the retention of referred cases in the healthcare system over follow up period. We further assessed levels of awareness, treatment and adequate control of hypertension and T2DM.

Results: A total of 631 participants were screened, (mean age 49 ± 16years, 73% female) from 6 Faith based Centres. More males than females reported smoking tobacco (14.5% vs. 0.7%) and been physically active (64.5% vs. 52.7%) while more females were obese (29.6 kg/m2 vs. 14.5 kg/m2) and had a higher mean waist circumference (89.0 cm IQR 75-116 cm vs. 84.2 cm IQR 72-107 cm), hip circumference (101.5 ± 10.6 cm vs. 96.4 ± 8.6 cm) and waist-to-hip ratio (0.86 ± 0.1 cm vs. 0.87 ± 0.1 cm) than males. The prevalence of confirmed hypertension and T2DM was 27.9% and 3.5% respectively with no observed sex differences. We observed deficits in the hypertension and T2DM care cascade with reported low awareness, treatment and uncontrolled levels. A 3-month follow up showed a retention in care of 100% in month one and 94.9% in the third month. There was an increase in treatment (39.4% in month-1 and 82.8% in month-3) and control (26.3% in month-1 and 76.3% in month-3) of hypertension and T2DM combined.

Conclusion: Faith-based centres have the potential to enhance the screening, linkage to the healthcare system, and management of hypertension and T2DM. This improvement over the routine system could lead to earlier diagnoses, a reduction in complications, and decreased premature mortality from cardiovascular diseases. Consequently, these efforts would contribute significantly to achieving SDG 3.

Keywords: Diabetes; Faith-based centres; Health Promotion; Hypertension; Primary prevention.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A diagram showing screening outcomes and subsequent cohort followed up. Data presented as n (%); the denominator is the total number of people screened (n = 631). Incidence refers to all news cases diagnosed from the suspected cases while prevalence the total of known and new cases confirmed from the suspected cases
Fig. 2
Fig. 2
Facilities and Health workers referred to in the Kasena Nankana districts; CHPS, community-based health and planning services
Fig. 3
Fig. 3
Hypertension (A) and T2D (B) care cascade in the Kassena Nankana districts
See this image and copyright information in PMC

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