Saving Lives in Rural Indonesia: How SMARThealth is Tackling Cardiovascular Disease
As the fourth most heavily populated country, the burden of cardiovascular disease (CVD) in Indonesia is particularly alarming, accounting for 1 in 3 deaths. The SMARThealth programme, developed by University of Manchester researchers to tackle the high risk of CVD in rural parts of Indonesia, is projected to prevent 120,000 deaths.
Research conducted by the SMARThealth team at the University, Gindo Tampubolon, Asri Maharani and Professor Delvac Oceandy shows 70% of those over the age of 40 are at risk of developing some form of CVD. Stark health inequalities between the urban and rural areas of the country, where access to health services is limited, means 70% of those with moderate to high risk of CVD are unable to access cardiovascular care.
Working in collaboration with researchers from the George Institute for Global Health in Australia and the University of Brawijaya and the District Government of Malang, the team designed the SMARThealth app as a low-cost intervention to tackle CVD in Indonesia. The app analyses blood samples in real time and using a clever algorithm, determines whether an individual’s CVD risk is normal, medium or high, with the latter indicating a 1 in 5 chance of hospitalisation or death within ten years. Through the app, the data collected is then transferred directly to health professionals.
Local health volunteers, known as kaders, were trained in the collection of blood samples, correct use of the app and in their knowledge of CVD and associated risk factors. The programme was initially piloted in eight rural villages in the district of Malang. Of the 12,000 people screened for CVD risk in two years, 6,579 were identified as being at high risk and subsequently 57% of them were given blood-pressure lowering medication. It is estimated that the trial resulted in a greater life expectancy for 3,750 people.
As part of its public health programme, the Malang District Government are scaling up the SMARThealth programme to reach 3 million residents, projected to prevent 120,000 deaths due to CVD.
Recognising the success of the programme, the Indonesian Ministry of Health awarded Malang District Government the Best Health Services Innovation Award in 2019, as well as the team winning the ‘Outstanding benefit to society through research’ award at the University’s annual Making a Difference Awards.
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