Launch of Capacity Building Initiative in India

Recognizing that Cardiovascular disease (CVD), including ischemic heart disease and strokes, are an existing public health challenge and a leading cause of death globally, the Public Health Foundation of India (PHFI) along with the World Heart Federation (WHF), Population Health Research Institute (PHRI), the American College of Cardiology (ACC) and Centre for Chronic Disease Control (CCDC), have launched the Certificate Course on Cardiovascular Disease and Stroke (CCCS). Rotary International is a strategic partner for the course.

The course has been endorsed by the Royal College of Physicians, London for five years and is supported by an educational grant from Sun Pharma Laboratories Ltd. The objective of the course is to build capacity, improve and enhance awareness amongst primary care physicians in the management of cardiovascular diseases that is an emerging threat in India.

 

Cardiovascular disease (CVD), including ischemic heart disease and stroke are the leading cause of death globally. In 2016 there were over 17 million CVD deaths, which is approximately a third of all deaths in the world. Most CVD events (eg. stroke, myocardial infarction, sudden death) occur in people who already have CVD, hypertension or are smokers. What makes the scenario grimmer is that currently, about 1 billion people have hypertension of which less than half are diagnosed and receive any Blood Pressure (BP) lowering treatments. Of those receiving treatment, fewer than 20% have their BP controlled. All these factors ultimately make the population highly susceptible to CVD and strokes. Of the 50 million people with CVD, fewer than 5 million receive at least three out of four of the recommended drugs for secondary prevention, making them more vulnerable.

In India, the Cardiovascular disease is a major cause of disability and premature death and is advancing rapidly. Overview of population surveys conducted over two decades in India reported a 9-fold increase in the prevalence of Coronary Heart Disease in India and it has been estimated that there will be doubling of deaths due to cardiovascular disease (CVD) in India.

Improving hypertension control and secondary prevention, (particularly in low & middle-income countries like India where use is lowest) along with reducing tobacco use is the most powerful strategy for reducing CVDs globally. Even a partial achievement of this strategy will achieve the WHO target of a 25% reduction in NCD premature mortality. Therefore there is a need to improve the capacity of Primary Care Physicians to implement these strategies in clinical practice.

Announcing this unique initiative, Prof. D. Prabhakaran, Vice President - Research and Policy, PHFI said, "The Public Health Foundation of India has been working actively towards improving health systems through capacity building of primary care physicians. Through collaborative efforts, we have successfully trained over 21,000 physicians in the management of various chronic conditions over the last 8 years. Cardiovascular disease (CVD) and stroke is the leading cause of death and disability in the World as well as in India.

It is important that our physicians are prepared to tackle this growing epidemic that is expected to become worse over the coming years owing to our ageing population. We are glad that internationally renowned institutions and national level experts have come together to design and deliver this program that aims to upgrade skills and core competencies of primary care physicians across India in the management of CVD and stroke. Over the next one year, approximately 1000 physicians will be trained at 50 centres spread across the country."

The aim of this course is to build the capacity of Primary Care Physicians (PCPs), who are the foundations of health care in all countries in the world. Between 50 per cent and 70 per cent of adults see their PCP every year for some ailment. This presents an excellent opportunity to implement strategies for prevention of CVD through opportunistic screening for hypertension and implementing simple lifestyle modification and drugs treatment for hypertension and for secondary prevention. Therefore by empowering family practitioners and other primary care personnel in CVD prevention substantial reductions in CVD is likely within the existing health care systems in the countries. The programme presents a model that can be scaled up in a few years to China, Latin America and Africa.

Speaking on the occasion of the launch of the program, Prof. Salim Yusuf, Past-President, World Heart Federationand Executive Director, Population Health Research Institute said, "The high burden of cardiovascular disease and stroke cannot be managed by specialists alone. Strengthening primary care is an important and critical step in combating this problem. The Certificate Course in CVD and Stroke is an excellent effort in this direction and this unique initiative being launched in India is sure to become a model for replication in other countries as well. The World Heart Federation and the Population Health Research Institute are thrilled to be a part of this wonderful program that is certain to have a positive impact on the CVD and stroke scenario in India."

The Certificate Course on Cardiovascular Disease and Stroke is a twelve months course (12 modular courses) with once-a-month contact sessions, which will be conducted on designated weekends at regional centres across India. The course has been designed and vetted by a panel of 16 national level experts and will be delivered by 50 regional faculty across India. The program has been conceptualized to train Primary Care Physicians (PCP) across the country with an objective to enhance their knowledge, skills and core competencies to address case management, counselling and referral of patients with cardiovascular disease. This will enable the PCP in early diagnosis and prompt referrals of patients, and also establish a referral linkage pattern.

The course utilizes a variety of teaching/learning techniques. Training in management of CVD and stroke will be complemented by providing the participants with various distinct case studies, group activities and assignments. The curriculum of the course covers topics such as stroke, coronary heart disease, myocardial infarctions, heart disease in women, rheumatic heart disease, peripheral arterial disease and ECG.

The candidate completing the course successfully shall be awarded a certificate that is jointly issued by the Public Health Foundation of India, World Heart Federation, Population Health Research Institute, American College of Cardiology, Centre for Chronic Disease Control and the respective regional faculty, and endorsed by the Royal College of Physicians, London.