CHWs and hypertension in rural India

29 January, 2020

Below are the citation and author summary of a new paper in PLoS Medicine, exploring the role of CHWs in blood pressure control.

CITATION: Effectiveness of a scalable group-based education and monitoring program, delivered by health workers, to improve control of hypertension in rural India: A cluster randomised controlled trial

Dilan Giguruwa Gamage et al.

PLoS Medicine 2020


Why was the study done?

Many regions of the world have inadequate or inaccessible health resources and health professionals to diagnose, monitor, or manage hypertension.

This gap could potentially be addressed by using non-physician community health workers (CHWs), who reside in the community and are available in sufficient numbers.

What did the researchers do and find?

In a cluster randomised controlled trial in 3 very diverse regions in rural India, 637 participants with hypertension from 5 clusters were recruited and randomised to the intervention, and 1,097 with hypertension from 10 clusters were recruited and randomised to usual care.

Every 2 weeks, CHWs educated people in the intervention clusters about hypertension and measured their blood pressure.

Blood pressure declined an average of 5.0/2.1 mm Hg more in the intervention group than the usual care group, and control of blood pressure improved.

What do these findings mean?

Our approach overcomes limitations in access to healthcare by utilising a CHW workforce that not only is local, but requires very little training.

This low-cost group-based education and monitoring intervention is a potentially scalable approach that could be implemented across other diverse settings in rural India, and globally.

Use of this approach may help reduce the emergence of cardiovascular diseases in low-resource settings.

Best wishes, Neil

Coordinator, HIFA Project on Community Health Workers - Supported by the World Health Organization

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: