The Lancet: Blood pressure control: a challenge to global health systems (3)

14 September, 2019

Massimo thank you for your posting.

I wish to comment on your points, as follows- my comments follow below your points: (your) point/proposal is the following:

Each hospital of the world should establish a service of BWt and BP checking to adults willing to know their condition. Totally free from charge.

My comment: I totally agree with you on this

The person will know his/her BMI and offered few recommendations. BP is also checked. Both parameters will be adequately reported in the Personal Health Booklet (PHB).

My comment: I also agree with you on this.

How much will 'my' service cost?

How far will it reduce mortality?

Very little to the first question, very much to the second one.

My comment: I don’t understand what you mean by, ‘Very little to the first question, very much to the second one’. Kindly explain what you mean.

No need to do research or studies here, when something new is valid, obvious, feasible and cheap(!) what is missed is its implementation.

My comment: I do not agree with you here. There are things that appear 'valid' but on further look into them (research) we find that they are not really valid. Until Plato (4th century) and finally Aristotle (330 BC), it was thought that ‘the world is flat’, but we now know differently. The world is not flat! (Flat Earth- Wikipedia (

Especially in health care we need to have proven facts and information so as to promote and protect lives. ‘Do no harm’ is a well-known dictum that must be adhered to by all health workers and we can only do so if we have research results that

validate health information that health workers use in their care of patients. Research may be costly but what is the price of life itself? What is the cost(s) of the wrong treatment?.

Persons are at the centre of health care, not doctors! Persons (I do not call them patients) need information on their health and to keep this information with them, well written in their PHB. It is their right...not a favour or concession by the system.

My comment: I agree with you here. The concept of ‘Patient centred/Person centred care’ has established the point of who is at the centre of health care delivery, whether we use the title patient or client or person.

Joseph Ana.

HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria. In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007.


Joseph is a member of the HIFA Steering Group:

Email: jneana AT