National level stakeholder’s cardiovascular disease (CVD) guideline dissemination forum

A national-level stakeholder’s CVD guideline dissemination forum was held on 14th March 2019 to sensitize key stakeholders on the CVD guidelines and deliberate on ways to accelerate their dissemination and implementation.

This forum brought together more than 60 national experts in the field of CVD as well as stakeholders who play a key role in efforts to address CVD. This report summarizes the key outcomes of the meeting as well as action points.

The objectives of the meeting were as follows:

  • To share the journey towards the development of the 1st National Cardiovascular disease guideline

  • To identify the barriers to guideline dissemination and implementation

  • To identify effective strategies, best practices and innovations that can be utilized in the dissemination and implementation of the CVD guideline

  • To identify the role of various stakeholders in the CVD guideline dissemination and implementation

  • To identify ways to measure the effectiveness of the dissemination and utilization of this guidelines

Participating Organizations

Ministry of Health (MOH) Non-communicable Diseases (NCDs), National AIDS and STI Control Programme (NASCOP)
Non-governmental organizations (NGOs) Amref Health Africa, Populations Services Kenya (PSK), Management Sciences for Health (MSH), Kidney Focus Kenya
Professional Bodies Kenya Association of Physicians (KAP), Kenya Medical Association (KMA), Kenya Cardiac Society, Nursing council of Kenya, Clinical Officers Council
Faith Based Christian Health Association of Kenya (CHAK)
Supply chain partners
Missions for Essential Drug Supply (MEDS)
Alliances NCD Alliance Kenya (NCDAK)
Youth-led organizations Young Professionals Chronic Disease Network, Stowelink
HIV implementing partners University of Maryland, Afya Jijini, Eastern Deanery AIDS relief program (EDARP)
Academic Academic Model Providing Access to Healthcare (AMPATH), UON – School of Medicine, UON – School of Pharmacy, Kenya Medical Training College (KMTC), Aga Khan University Hospital
County representatives
Nairobi, Isiolo, Nakuru, Nyandarua, Kisumu, Kitui
Referral Hospitals/teaching Kenyatta National Hospital (KNH)
Research African Population and Health Research Centre (APHRC)
Health providers – County Hospitals Gatundu Sub-county Hospital, Mbagathi County referral hospital, Kayole 2 Health Centre

During the forum, the barriers highlighted that would hinder effective dissemination and implementation of the guideline were as follows:

  • Limited applicability of the guidelines at the primary health care level. This is due to lack of resources (human, commodities, laboratory investigations) and capacity to provide care at lowest levels of health system

  • Shortage of human resources

  • Lack of access to affordable essential laboratory investigations and medication to support implementation of the guideline

  • Inadequate financial support for Non-Communicable Diseases (NCDs) programming.

Outcomes of the national-level stakeholder’s CVD meeting

  • Develop a standardized dissemination package (Job aids, ToT training, pre-service training)

  • Utilize existing platforms/programs/stakeholders to disseminate the guidelines (HIV program, societies, associations, supply chain partners, private sector)

  • Leverage on technology to scale up dissemination (App, EMR, WhatsApp, email)

  • Develop an M/E framework to monitor progress and outcomes.

  • Advocate for sustained availability of essential CVD commodities and supplies especially at primary health care level

  • Advocate for increased and sustained resource allocation towards NCD programming

2. Cardiovascular Disease Guideline Trainer Of Trainees (TOT) Workshop, 19th -21st June 2019

Through funding from Access Accelerated (AA), World Heart Federation (WHF) and Kenya Cardiac Society (KCS) in collaboration with the Ministry of Health will be disseminating the recently launched Cardiovascular disease guidelines in 5 counties: Isiolo, Kitui, Nyandarua, Kisumu and Nakuru. The initial phase involves training of CVD Trainer of Trainees (TOTs) who will champion dissemination of the guideline at the county and sub-county level.

The TOT training which was successfully held between 19th – 21st June 2019and brought together 25 participants nominated from five counties for a 3-day training workshop which was held in Nairobi. The workshop focused on four modules of the CVD guideline: CVD prevention, Hypertension, Heart Failure and Rheumatic Heart Disease (RHD).

The faculty was led by members from KCS including the current President Dr. Bernard Gitura and Dr. Bernard Samia and Dr. Lilian Mbau. In attendance was also Dr. Ephantus Maree from the Division of NCDs at Ministry of Health.

The sessions were facilitated by distinguished faculty drawn from KCS membership notably Dr. Bernard Gitura, Prof. Elijah Ogolla, Pro. Gerald Yonga, Prof. Christine Jowi and Prof. Fred Bukachi. These sessions were interactive and elicited good participation from the participants.

The participants also spent some time deliberating on the potential barriers that may hinder the dissemination of the guidelines within their respective counties and ways in which these can be mitigated. The training materials used were availed to the participants after the training to assist them cascade the knowledge at county level.

Following this training, KCS is planning for county level dissemination workshops across the 5 counties targeting a total of 300 health professionals drawn from health facilities across each county. The TOTs will play a key role in supporting the organization and facilitation of these workshops as well as participate in mentorship of health workers in their respective counties. These workshops will be held in September and October 2019.