Abstract
IntroductionSub-Saharan Africa has a disproportionate burden of disease and an extreme shortage of health workforce. Therefore, adequate care for emerging chronic diseases can be very challenging. We implemented and evaluated the effectiveness of an intervention package comprising telecare as a mean for improving the outcomes of care for hypertension in Rural Sub-Saharan Africa.MethodsThe study involved a telemedicine center based at the Yaounde General Hospital (5 cardiologists) in the Capital city of Cameroon, and 30 remote rural health centers within the vicinity of Yaoundé (20 centers (103 patients) in the usual care group, and 10 centers (165 patients) in the intervention groups). The total duration of the intervention was 24 weeks.ResultsParticipants in the intervention group had higher baseline systolic (SBP) and diastolic (DBP) blood pressure, and included fewer individuals with diabetes than those in the usual care group (all p < 0.01). Otherwise, the baseline profile was mostly similar between the two groups. During follow-up, more participants in the intervention groups achieved optimal BP control, driven primarily by greater improvement of BP control among High risk participants (hypertension stage III) in the intervention group.ConclusionAn intervention package comprising tele-support to general practitioners and nurses is effective in improving the management and outcome of care for hypertension in rural underserved populations. This can potentially help in addressing the shortage of trained health workforce for chronic disease management in some settings. However context-specific approaches and cost-effectiveness data are needed to improve the application of telemedicine for chronic disease management in resource-limited settings.
Highlights
Sub-Saharan Africa has a disproportionate burden of disease and an extreme shortage of health workforce
1187 calls were received by telemedicine center from remote clinics in the intervention groups during the study period; 791 unique provider’ call were made
In this pilot TELEMED-CAM project, we have demonstrated the significant beneficial effect of an intervention package comprising telecare support on average blood pressure levels and control rates for hypertension among adults Cameroonian receiving ongoing chronic care in rural health facilities
Summary
Sub-Saharan Africa has a disproportionate burden of disease and an extreme shortage of health workforce. We implemented and evaluated the effectiveness of an intervention package comprising telecare as a mean for improving the outcomes of care for hypertension in Rural Sub-Saharan Africa. Conclusion: An intervention package comprising tele-support to general practitioners and nurses is effective in improving the management and outcome of care for hypertension in rural underserved populations. This can potentially help in addressing the shortage of trained health workforce for chronic disease management in some settings. The cost of a GSM phone call was $0.2/ minute, that of a Short Message Service (SMS) $0.1, while an hour of Internet connection cost less than $2 This may greatly reduce the cost of a telemedicine nowadays, as compared with years back when satellites communication had to be used. It becomes possible for a specialized health facility in an urban area, to oversee health centers in rural areas, run by general practitioners or nurses for the management of CVD and risk factors
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
