By Ashim Sanyal
Hypertension quietly affects over a billion people worldwide, presenting a significant risk without noticeable symptoms. When overlooked, it becomes a leading cause of sudden cardiac arrest, progressive kidney complications, and fatal consequences. High blood pressure is among the most important risk factors for cardiovascular diseases. It remains poorly controlled due to low awareness about hypertension, lack of appropriate care through primary care and poor follow up. Accounting for almost half of all heart diseases and stroke-related deaths worldwide, addressing hypertension has become imperative. According to the 2019-20 National Family Health Survey (NFHS-5) the prevalence of hypertension was recorded at 24% among women and 21% among women, up from 19% among men and 17% among women in the previous survey (2015-16). Countries are increasingly recognizing the urgency for extensive interventions and empowering primary healthcare to lead outreach efforts. India stands as a beacon, demonstrating unwavering political commitment in the battle against this lethal threat.
Civil society has a vital role to play in the battle against hypertension. The initiatives must focus on the most excluded, and hard-to-reach rural population to expand comprehensive healthcare services at the community and household level. Fortunately, the government has acknowledged that the battle against hypertension has to start at the primary healthcare level. Strengthening primary healthcare will not only reduce mortality but also significantly lessen the need for secondary and tertiary care and their related costs. Screening of hypertensive individuals is crucial to prevent morbidity and mortality associated with hypertension. Primary field-level frontlineworkers, community health workers and nurses are crucial for delivering high-quality community-based services, especially for hypertension and other non-communicable diseases. The community healthcare workers are involved in ensuring the uninterrupted supply and availability of hypertension protocol medicines and help in scaling up hypertension control in their respective areas. With the world staring at recession and its ripple effect on incomes and health services to the disadvantaged, NGOs have stepped in admirably to fill the gap by reaching out to marginalised sections.
A recent survey by the Indian Council of Medical Research (ICMR)-National Centre for Disease Informatics & Research (NCDIR) revealed that nearly 29% of adults in India are affected by hypertension. A multi-sectoral approach has become a prerequisite to fight hypertension. Collaborative efforts involving the private sector, civil society, and the media are crucial in realizing the vision of health for all, as outlined in the National Multisectoral Action Plan and Control of Common NCDs (2017-2022). This inclusive approach ensures a comprehensive strategy to tackle the challenges posed by hypertension and other health threats.
Preventing and managing hypertension hinges on various factors, including lifestyle adjustments and addressing dietary risks such as excessive alcohol and tobacco consumption, high-salt diets, and obesity. Therefore, comprehensive interventions that integrate multiple strategies, as delineated in the HEARTS package, prove most effective. This entails ensuring medication availability, adopting protocol-based approaches, fostering patient-centric care, strengthening overall healthcare systems, and cultivating enhanced community awareness. Implementing these multifaceted strategies collectively will enhance the effectiveness of hypertension prevention and control measures. Civil society organisations, including Consumer VOICE, have been playing an instrumental role in spreading awareness among the people and primary healthcare workers across states in India to ensure that more and more people are screening their BP regularly and adhering to treatment.
Simple, yet critical measures like screening using digital BP monitors, counseling and streamlined treatment using personalized medications at easily accessible health facilities, hold the potential not only to prevent health crises but also to significantly alleviate, if not entirely prevent, out-of-pocket expenses that often drive people into poverty. By focusing on these modest interventions, we can potentially avert health catastrophes and subsequently diminish the need for expensive treatments. In rural India, where a robust Primary Health Care system is already in place, there exists an opportunity to enhance their quality and broaden the spectrum of services offered. The establishment of over 150000 Ayushman Bharat Health and Wellness Centres (AB-HWC) and the operationalization of telemedicine and digital health services have reached approximately 140 million people. This concerted effort aims to provide comprehensive healthcare access, leveraging technology and expanding services in remote areas, ultimately uplifting the standards and inclusivity of healthcare services in India.
The government of India received the 2022 UN Interagency Task Force and WHO Special Programme on Primary Health Care Award for its highly impactful, large-scale hypertension intervention within the existing primary healthcare system. To ensure that these achievements propel us closer to our overarching objectives, it is crucial for all key stakeholders – such as community-based organizations, Gram Panchayats, public health experts, healthcare providers, allied health professionals, and frontline workers – to collaborate for the last-mile reach. Community-based interventions stand out as a promising solution for enhancing hypertension management and ensuring medication adherence. These collaborative efforts among stakeholders are pivotal in alleviating the financial burden NCDs place on households and communities.
(The author is a CEO, Consumer voice. Views expressed are personal and do not reflect the official position or policy of the FinancialExpress.com.)