A University School of Nursing, in partnership with Omni-Med, a non-governmental agency (NGO) that provides sustainable, and evidence-based health programs in the Mukono district, developed an innovative plan to educate the community health workers (CHW), as the first level of care for villagers, on HTN diagnosis, education, and medical referral. CHWs are cost effective in screening for cardiovascular disease in medically low resource areas (Gaziano, et al, 2015).
Aims: To train CHWs in measuring and recording blood pressures (BP) on local villagers and referring those with BP’s greater than 160/90 to a level 2, 3, or 4 health center, in addition to educating them on lifestyle changes to improve BP.
Methods: During the fall 2017 and 2018, the nurse-led teams of 5-7 pre-licensure nursing students and a faculty member trained 45 and 75 CHWs in measuring, recording, and educating people in their village (villagers) about BP and HTN. Prior to departure, manual BP equipment was acquired by the students and faculty. A fund-raising campaign was initiated, in addition to obtaining donated or at cost BP equipment from the SONs equipment partners. Once CHWs were trained in manual BP, they were educated about lifestyle changes to lower BP, given documentation forms for tracking BP results, and follow-up communication with the HTN control liaison within Omni-Med.
Results: In the fall of 2017, 45 CHWs were trained in BP monitoring. Immediately after instruction, all CHWs were evaluated on BP accuracy, with the trainer testing BP simultaneously and evaluating a 5 stop method developed by Amarchand, Sharma, & Krishan. At the conclusion of the training sessions, 100% of the 45 trained CHWs were able to correctly test BP measured by supervisor re-test and the 5 point method.
In March, 2018, follow-up evaluation was done on the originally trained CHWs from 2017. On re-evaluation, performed four months after initial training, there was 95% accuracy in BP testing, using supervisor re-test and 5 point method developed by Amarchand, et al.
In fall 2018, 51 un-trained CHWs were trained on BP monitoring and education; along with 21 follow-up evaluation on those trained in fall, 2017. Of both new trainees and follow up trainees, there was 100% accuracy in BP measured by supervisor re-test and the 5 point method developed by Amarchand.
Conclusions: The health of a global community is dependent upon partnerships that are embedded in the community, with sustainable, evidence-based interventions based on realistic goals and a well-conceived evaluation plan. A nurse led initiative, partnering with a local NGO, focused on training CHWs on BP screening and education has led to over 90 CHWs successfully monitoring for HTN in their villages, training the villagers on healthy lifestyle, and referring those with HTN to local health centers for treatment. Successful monitoring of this program, with the HTN control liaison within Omni-Med, helps guarantee sustainability.