Health Worker Training Is Improving Hypertension Care and Prevention in Senegal

October 31, 2019
During interviews with almost 2,000 health workers and clients in Dakar, Senegal, IntraHealth International found that some 40% of health workers had not been trained to care for clients with hypertension, and 83% of clients who did not have hypertension knew no more than a single warning sign. But a 2019 evaluation reveals significant progress in under two years.
The results from our 2017-2018 situational analysis uncovered gaps in hypertension care and prevention in Dakar, including insufficiencies in equipment, hypertension management skills, and patient education.
Those results helped guide the Better Hearts Better Cities initiative in Senegal—implemented in partnership by IntraHealth, PATH, and the local health authorities—which is part of a global urban health initiative in run by the Novartis Foundation. Its goal is to improve the quality of hypertension management and reduce cardiovascular morbidity and mortality in Dakar.
Hypertension is a dangerous precursor to and prime risk factor for heart disease and stroke, which is now the fifth-leading cause of death in Senegal. The World Health Organization estimates that 42% of all deaths in Senegal are caused by noncommunicable diseases (NCDs) like hypertension. Throughout sub-Saharan Africa, the incidence of stroke has increased 46% since 1990.
In some cities, the prevalence of hypertension is as high as 40%.

“When I was starting out as a young doctor here in Senegal, noncommunicable diseases were thought to be a thing for rich people,” says Joseph Barboza, a physician in Senegal and director of IntraHealth’s Better Hearts Better Cities team in Dakar. “It used to be infectious diseases like measles, malaria, and meningitis that brought people to the emergency room. Now most of those emergencies are caused by NCDs, usually hypertension. In some cities, the prevalence of hypertension is as high as 40%.”
Since its beginning in Dakar in 2017, Better Hearts Better Cities has helped train and provide supportive supervision to 667 health workers across three districts in the city. And it’s paying off. A July 2019 evaluation* found strong improvements in hypertension awareness and prevention among health workers in one of those districts (Dakar Ouest), including: