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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 29, No 5, September/October 2018
AFRICA
333
Welcome address and review of draft modules
Prof Elijah Ogola (Kenya), the chairperson for the meeting,
welcomed the audience to Nairobi and congratulated the PHFI
for their marvellous work and relentless effort to share their ideas
with other partners.
Dr Saad Subhani (Sudan), president of PASCAR, welcomed
the delegates and thanked all the stakeholders for their support
of and commitment to this inaugural meeting. In his opening
address, he gave a brief overview of PASCAR (founded by Prof
Ayodele Falase), explaining it as an organisation of physicians
and surgeons across Africa, involved in the prevention and
treatment of cardiovascular diseases. He further spoke briefly on
the organogram of PASCAR, its governing council task forces,
with representation from key role players in cardiovascular
sub-specialties.
Dr Subahi’s address was followed by a short speech by
Prof Anastase Dzudie (Cameroon), chair of the hypertension
task force, who set the pace for the meeting. He gave a brief
overview of the burden of hypertension in Africa and the
roadmap to achieving 25% control by 2025. In his remarks, he
highlighted target six of the 10-point action plan, identified by
the PASCAR hypertension task force, which includes a shifting
of the paradigm of hypertension management by promoting
a task-sharing approach, and the certificate course in the
management of hypertension in Africa (CCMH-Africa) will be
one such initiative.
He informed the gathering about the vast coverage of this
course, with enormous success in India, and explained how a
similar approach will be customised to the African context. In
the African context, such a project has the potential to build
on the existing health systems and strengthen a direct referral
linkage for the management of hypertension between nurses,
general practitioners and specialists.
Prof Neil Poulter, president of the ISH, expressed how
proud they were to be part of the collaboration between
PHFI and PASCAR in extending the reach of a certified
course in the management of hypertension from India to the
African continent. He also illustrated how ISH is committed
to promoting/encouraging the advancement of scientific
research and its application for the prevention and management
of cardiovascular diseases around the world. His two key
aspirations are to support younger members (organisation
members) and reach out to as many countries globally as
possible. He highlighted the May Measurement Month survey
as an example of such aspiration.
Prof Francesco Cappuccio, president of the BIHS, presented
opening remarks on behalf of his organisation, highlighting
briefly the partnership between BIHS and CCMH, and the
journey in making this initiative possible. He warmly welcomed
this new initiative, which would provide access to valuable
specialist training to many doctors and health professionals in
Africa, sorely needed on a continent where the double burden
of disease (communicable and non-communicable) is projected
to cause high mortality and morbidity rates and long-term
disabilities.
Dr Sandeep Bhalla (India), programme director, Centre for
Control of Chronic Conditions and Injuries (CCCI), gave the
programme overview of CCMH-Africa. He mentioned that the
journey of this capacity-building initiative was started by the
PHFI in the year 2015 and how the programme had received
an overwhelming response from its participants. He also graded
the compliance rate a success in India and stated how several
government institutions are adopting the programme for the
training of their medical officers. Salient features of the course
were outlined and the audience was briefed on the various
models. In his second presentation, he gave a rundown of the
course implementation, and proposed methods to facilitate this
task.
Finally, Dr Arun Jose (India), programme manager CCMH-
India, apprised the gathering about the CCMH-Africa course
design protocol and group working guidelines, followed by the
release of the course brochure.
Overall discussion and way forward
The group recognised the urgent need to develop a course that
will empower and improve the core competencies of primary care
physicians in the management of hypertension. To accomplish
the objectives of the meeting, four group experts were formed
to review the modules, with one rapporteur from each group to
facilitate the discussion and record notes/comments. Each group
of experts then reviewed the designated module and suggested
changes in that particular module. In the final session, one
representative from each group presented the modules they had
reviewed and their suggested changes to the rest of the audience
for their feedback. The session witnessed intense discussions,
and general consensus was achieved on each topic. After the
in-depth brainstorming sessions, the curriculum was reviewed
meticulously and the active participation of the experts was
noteworthy.
Roll-out plan for CCMH-Africa
PASCAR
regional high impact [train the trainer (T
3
)]
× 3 trainers per country aligned per region
Country high-impact course [T
3
]
Train the trainer at “regional and national congresses”
Full non-prescriber course – 5 contact over 5 months
[GP train referral non-prescribers]
African key opinion leaders meeting
In country: full prescriber certificate courses –
10 contacts over 10 months
[national trainers train prescriber (GP)]
French
Africa
English
Africa
Arabic
Africa
Portuguese
Africa
Local
language
adaptation
Fig. 1.
Roll-out plan for CCMH-Africa (ideal model).