World Heart Federation

Access Accelerated and the World Heart Federation (WHF) have partnered since 2018 to strengthen the delivery of high-quality cardiovascular health and to accelerate advocacy of cardiovascular disease treatment and prevention at national and global levels. Access Accelerated supports WHF to undertake three key pillars of work: empowering local advocates; convening stakeholders to drive more effective health policies; and sharing knowledge and tools to advance action on CVDs.

WHF’s response and adaptation to emerging needs highlight the importance of having flexible funding and working with local actors towards a common goal. WHF’s work at national level embraced local actors and stakeholders to ensure the successful implementation of activities. The focus given to underserved communities, including women of African descent in Colombia and people living in rural areas in Kenya, showcases the equity lens through which Access Accelerated and WHF are improving NCD outcomes.

The implementation of WHF’s work in Kenya was sustained by engaging local actors including county leadership and KCS. Projects were implemented by WHF local members, the Colombian Heart Foundation, the Colombian Society of Cardiology and the Kenya Cardiac Society, highlighting WHF’s commitment to working with local stakeholders who are an integral part of the local community and are ideally positioned to implement the project on the ground. By strengthening the implementation of standards for cardiovascular disease service provision through WHF, the Access Accelerated consortium is able to foster an environment of quality assurance and improved care for people living with and at risk from the world’s top killer.

ACTIONS, OUTCOMES AND IMPACT IN 2022

Through the second phase of Access Accelerated, the World Heart Federation (WHF) trained over 500 people to become advocates for cardiovascular health and to equip health professionals with tools to monitor and manage cardiovascular disease and its risk factors. In the last two years, WHF and its members organized four global events and produced nearly 20 knowledge products and guidelines which work to strengthen service delivery and set norms which support the prioritization and care of cardiovascular disease (CVD) at global and local levels. These figures speak to WHF’s three key pillars of work: empowering local advocates, convening stakeholders to drive more effective health policies, and sharing knowledge and tools to advance action on cardiovascular disease.

Throughout the partnership, WHF supported 12 countries in Africa to collect data on the CVD healthcare delivery and policy landscape and to strengthen national and subnational capacities to implement and use cardiovascular disease guidelines to improve health outcomes and care. WHF also released key position statements that inform the CVD community, especially in LMICs, including on how to improve access to essential medicines for circulatory diseases, how policymakers can drive action on circulatory health, and an update of its Global Roadmap on Hypertension.

With support from Access Accelerated, WHF leveraged its convening power to sponsor global events including in the Global Summits on Circulatory Health in 2018 and 2019 and the 2021 the World Heart Summit on the theme of “Time to Act on Obesity.” Global events brought together opinion leaders, ministers of health, and industry leaders, enabling a culture of knowledge exchange.

WHF’s local partner in Kenya, the KCS, presented the story of its successful implementation of an integrated CVD and diabetes guideline during a panel discussion at the 2022 Heart Summit. Building on these efforts to collect data and convene stakeholders nationally, WHF has worked with two of its members and the support of Access Accelerated to implement projects improving access to cardiovascular disease care. KCS, in collaboration with the Kenyan Ministry of Health used momentum from the national Roundtable to adapt global guidelines to the national settings to improve utilization. Similarly, in collaboration with the Colombia Society of Cardiology and Colombian Heart Foundation, WHF built on a successful national roundtable to implement a project to empower women health workers and community leaders in black communities to provide cardiovascular health education, screening and follow-up to women within the community.

Throughout the partnership, WHF supported 12 countries in Africa to collect data on the CVD healthcare delivery and policy landscape and to strengthen national and subnational capacities to implement and use cardiovascular disease guidelines to improve health outcomes and care.

CASE STUDY: Norm and standard-setting for improved equity in CVD outcomes

Cardiovascular disease can be prevented or controlled through timely detection, which the World Heart Federation (WHF) promotes by developing effective standards for care and encouraging social norms that empower individuals to seek care. With partnerships in over 100 countries, WHF improves equity in CVD outcomes through a refined model of stakeholder engagement, knowledge sharing, and capacity building for advocates and healthcare providers.

In Kenya, a prosperous partnership with the Kenya Cardiac Society (KCS) opened the doors to nationwide collaboration with health professionals and advocates who share WHF’s vision of achieving equitable CVD outcomes. KCS first turned to WHF and Access Accelerated in 2018 to request support in the dissemination and implementation of new CVD guidelines, particularly in rural areas which have historically lacked access to NCD services. Over the years this partnership gave way to a coalition of stakeholders including community groups, county governments, industry, academic institutions, and professional societies. Coordination between these different groups has been both robust and resilient, overcoming health worker strikes and COVID-19 disruptions to provide 22 national and county level workshops for the dissemination of CVD guidelines. This campaign achieved such success that KCS was invited to present its results at the Annual Scientific Congress, and it expanded its mandate to include the dissemination of guidelines for diabetes in addition to CVD.

To supplement its work with local and national implementing partners, WHF leverages its technical expertise to produce global analysis on specific aspects of circulatory health such as health system barriers to improving hypertension care. The “Roadmap for Hypertension update” supported by Access Accelerated, identifies a series of roadblocks and potential solutions to help improve access to hypertension prevention, detection and treatment in different settings. The Roadmap provides a framework for local partners such as KCS to map their situation and identify policies or programs that can be implemented to overcome identified challenges.

WHF’s work on norm and standard-setting reveals that creating local communities and generating knowledge are essential to advance the embeddedness of enhanced capacities among service providers. This means that multiple local actors interact and create social capital and connective tissue, while also having advanced technical knowledge on specific pain points. Identifying and thinking creatively about solutions is thus made possible.

CASE STUDY: Achieving gender equity in CVD outcomes

Research from different countries suggest that women may have higher rates of in-hopsital and post-discharge mortality following a heart attack. CVD presents differently and at different stages of life for men and women, and prevailing standards of care fail to address this gendered discrepancy in treatment outcomes. With support from Access Accelerated, World Heart Federation (WHF) is empowering female leaders and patient advocates to develop and implement gender sensitive guidelines for CVD diagnosis and treatment.

WHF’s Act with a Woman’s Heart project exemplifies the federation’s commitment to closing gender disparities in CVD. Through a partnership with the Colombian Heart Foundation and Colombian Society of Cardiology, the project built enabling environments for improved CVD outcomes in three cities on Colombia’s Caribbean coast. These communities historically lacked access to NCD services. They are home to many people of African descent who are at a particularly high risk for blood pressure. Act with a Woman’s Heart focused on empowering female health professionals in these underserved communities to prevent and manage heart disease, training 320 women of African descent in actionable strategies to mitigate CVD risk factors and disseminate guidelines for effective care. The training curriculum espouses “care as a lifestyle,” tasking participants with promoting a culture of healthy living for their communities and encouraging individuals to access NCD services.

In addition to the work in Colombia, WHF advances the visibility of women as leaders in the field of CVD care. Dr. Lilian Mbau is the Chief Executive Officer of WHF’s local partner in Kenya, the Kenya Cardiac Society, and she is also a member of WHF’s Emerging Leaders Programme that empowers the next generation of leaders to shape the future of cardiovascular health. WHF’s work in Kenya achieved gender parity across service providers, which is rare in cardiovascular disease.

Day by day, gender disparities in cardiovascular disease are being reduced through WHF’s coordinated action on three fronts. First, the implementation of gender-sensitive guidelines and standards of care help healthcare providers to appropriately respond to women’s health needs. Further, women cardiologists and other healthcare workers are developing professional acumen and becoming leaders in the NCD response. Lastly, women living with CVD and other NCDs are being empowered to advocate for patientcentered policies and health services.

WHF’s work to emphasize women and their CVD needs offers a key lesson on how flexible funding enables organizations to dig deeper into the needs of their target populations. It also showcases that facilitating knowledge exchange from global to local centers is a low-hanging fruit to create long-term, sustainable community and patient-centric care.