Cardio Vascular Disease Risk Assessment by Medical Officers According to the Guidelines at Healthy Lifestyle Centers in Western and North Western Provinces and the Factors Affecting Implementation of Guidelines

Abstract

Introduction: Healthy Lifestyle Centers (HLC) were established in 2011 to carry out Cardiovascular Disease (CVD) Risk Assessments and follow up with patients. The capacity of primary care institutions (PCI) for CVD risk assessment has not been studied in the recent past.Objective: To evaluate the existing CVD risk assessment guideline and assess its application process by Medical Officers (MOs) and facilities available at HLCs for CVD risk assessment.Methodology: A descriptive study with three components was carried out. Component one – CVD risk assessment Guideline evaluated through Key informant interviews (KII); component two- assessment of the Knowledge and practices on CVD risk assessment of all MOs working in HLCs using a self-administered questionnaire and an observational checklist; component three- assessment of available facilities and resources to carry out CVD risk assessment using a checklist.Results and Discussion: The study was conducted in 141 HLCs accessible during the Covid period. Assessment of CVD risk assessment guidelines showed Problems in methodological standards and in the identification and summary of evidence. MOs need to gain Knowledge in screening those under 35 years, in reading the WHO/ISH Risk Prediction Chart and in advising on further management and follow-up. All HLCs have at least one medical officer, but there is a lack of nursing officers and health care assistants.Conclusions and recommendations: There was a gap in Knowledge in screening criteria and management of those under 35 years of age. It is recommended to carry out training at national level every six months so all staff newly appointed to primary care could be trained. It is also recommended to appoint at least one nursing officer or a Public Health Nursing Officer (PHNO) to an HLC.