Abstract
To examine the feasibility of using community health workers (CHWs) to implement cardiovascular disease (CVD) prevention programmes within faith-based organizations in Accra, Ghana. Faith-based organization capacity, human resources, health programme sustainability/barriers and community members' knowledge were evaluated. Data on these aspects were gathered through a mixed method design consisting of in-depth interviews and focus groups with 25 church leaders and health committee members from five churches, and of a survey of 167 adult congregants from two churches. The delivery of a CVD prevention programme in faith-based organizations by CHWs is feasible. Many faith-based organizations already provide health programmes for congregants and involve non-health professionals in their health-care activities, and most congregants have a basic knowledge of CVD. Yet despite the feasibility of the proposed approach to CVD prevention through faith-based organizations, sociocultural and health-care barriers such as poverty, limited human and economic resources and limited access to health care could hinder programme implementation. The barriers to implementation identified in this study need to be considered when defining CVD prevention programme policy and planning.
Highlights
In sub-Saharan Africa, cardiovascular disease (CVD) has risen dramatically and has become a leading cause of morbidity and mortality.[1,2,3] According to The world health report, in 2001 CVD accounted for 9.2% of all deaths in the African region.[4]
This study investigated the feasibility of having community health workers (CHWs) implement a CVD prevention programme in faith-based organizations
This is the first study that explored Ghanaian churchesâ capacity and experience in conducting health programmes, and our results suggest that the CHW model for CVD prevention can be applied in faith-based organizations
Summary
In sub-Saharan Africa, cardiovascular disease (CVD) has risen dramatically and has become a leading cause of morbidity and mortality.[1,2,3] According to The world health report, in 2001 CVD accounted for 9.2% of all deaths in the African region.[4] In Accra, Ghana, CVD was the leading cause of death in 1991 and 2001.5. While communicable diseases continue to drain health resources in sub-Saharan Africa, the rising CVD epidemic poses a new public health challenge. Poverty and health-care worker shortages have seriously hindered the response to this mounting non-communicable disease burden.[2,6,7,8] Cost-effective strategies to prevent, detect and control CVD are urgently needed. Since 2000, volunteer-based CHW programmes have been included in Ghanaâs Community-based Health Planning and Services (CHPS) initiative, a national policy programme that was developed to mobilize resources to support community-based primary care.9The CHPS requires six steps: (i) preliminary planning, (ii) community entry, (iii) creating community health compounds, (iv) posting community health officers to community health compounds to provide health services, (v) procuring essential equipment, and (vi) training CHW volunteers.[9,10]
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