Photo by Nana Kofi Acquah courtesy of the Novartis Foundation

IntraHealth International is partnering with the Novartis Foundation, the Senegal Ministry of Health and Social Action, PATH, local health officials, community-based organizations, and other local stakeholders to address hypertension and improve cardiac health among the population of Dakar.

Through the new initiative, Better Hearts Better Cities – Dakar, the ministry will test evidence-based, scalable approaches in Dakar that have the potential to thwart the rise of hypertension and other noncommunicable diseases (NCDs) throughout Senegal and the region.

NCDs kill more than 40 million people worldwide every year, and more than 80% of NCD-related premature deaths occur in low- or middle-income countries. In Senegal, the World Health Organization estimates that 34% of all deaths are due to NCDs.

Of all chronic conditions, hypertension—a risk factor for coronary heart disease and stroke—is the most common.

The incidence of stroke—the major clinical outcome of uncontrolled hypertension—has increased 46% since 1990 in sub-Saharan Africa and is now the fifth-leading cause of death in Senegal.

According to Senegal’s 2015 STEP Survey, 29.8% of people 18 to 69 years old are estimated to have hypertension, but few are aware of their condition (28.4% in a study conducted in Dakar). Even fewer are taking antihypertensive medication (17%), and less than 8% have their blood pressure under control. Women are more often affected than men (26% vs. 22%), and hypertension’s prevalence increases starkly with age: from 11% of women aged 18–29 to 57% of women 60–69 years old.

The incidence of stroke—the major clinical outcome of uncontrolled hypertension—has increased 46% since 1990 in sub-Saharan Africa and is now the fifth-leading cause of death in Senegal.

The initiative will take a multidisciplinary, scalable, sustainable approach to hypertension management at all levels of care, from primary prevention through treatment at referral health centers. Dakar is one of three cities where the Novartis Foundation— a philanthropic organization which strives to have sustainable impact on the health of low-income communities through a combination of programmatic work, health outcomes research, and its translation into policy to tackle global health challenges—is testing approaches to address hypertension in urban areas. The other cities are Ulaanbaatar, Mongolia, and a city in Brazil to be announced later this year.

“The rising incidence of hypertension and other NCDs in low- and middle-income countries threatens to overburden health systems that are already struggling to expand access to health services,“ says Pape Gaye, IntraHealth’s president and CEO. “We’re thrilled to partner for the first time with the Novartis Foundation on this initiative in Dakar. The foundation’s commitment to using and generating evidence, engaging communities, and collaborating with local authorities aligns with our own values—and our experience of what works.”

The underlying causes of poor health are complex, spanning multiple sectors and extending beyond just poor access to medical care.

Together, the program’s partners will:

• Develop a technical package to improve hypertension services, including revised standard operating procedures, care algorithms, a registry, and a continuous quality improvement system.
• Improve the capacity of health providers to screen, diagnose, refer, and manage hypertension cases among the Dakar city population.
• Promote behavior change and healthy behaviors to prevent hypertension within the community.
• Improve access to and availability of hypertension medicines.
• Integrate hypertension care programs into workplaces.

The findings from the initiative will inform the Ministry of Health and Social Action and other stakeholders’ approaches to preventing and treating hypertension throughout Dakar and beyond. 

“The most important asset of a city is the health of its citizens,” says Dr. Ann Aerts, head of the Novartis Foundation. “The underlying causes of poor health are complex, spanning multiple sectors and extending beyond just poor access to medical care. These challenges cannot be tackled by one organization alone. We look forward to working together with Ministere de la Santé et de l’Action Sociale, IntraHealth, PATH, and our other partners to find holistic solutions for healthier cities, communities, and hearts.”