Fostering cardiovascular health at work – case study from Senegal

Abstract

Background Of the 15 million annual premature deaths from non-communicable diseases (NCDs), 85% occur in low- and middle-income countries (LMICs). Affecting individuals in the prime of their lives, NCDs impose severe economic damage to economies and businesses, owing to the high mortality and morbidity within the workforce. The Novartis Foundation urban health initiative, Better Hearts Better Cities, was designed to improve cardiovascular health in Dakar, Senegal through a combination of interventions including a workplace health program. In this study, we describe the labor policy environment in Senegal and the outcomes of a Novartis Foundation-supported multisector workplace health coalition bringing together volunteering private companies. Methods A mixed method design was applied between April 2018 and February 2020 to evaluate the workplace health program as a case study. Qualitative methods included a desk review of documents relevant to the Senegalese employment context and work environment and in-depth interviews with eight key informants including human resource representatives and physicians working in the participating companies. Quantitative methods involved an analysis of workplace health program indicators, including data on diagnosis, treatment and control of hypertension in employees, provided by the coalition companies, and a cost estimate of NCD-related ill-health as compared to the investment needed for hypertension screening and awareness raising events. Results Senegal has a legal and regulatory system that ensures employee protection, supports social security benefits, and promotes health and hygiene in companies. The Dakar Workplace Health Coalition comprised 18 companies, with a range of staff between 300 and 4′220, covering 36′268 employees in total. Interviews suggested that the main enablers for workplace program success were strong leadership support within the company and a central coordination mechanism for the program. The main barrier to monitor progress and outcomes was the reluctance of companies to share data. Four companies provided aggregated anonymized cohort data, documenting a total of 21′392 hypertension screenings and an increasing trend in blood pressure control (from 34% in Q4 2018 to 39% in Q2 2019) in employees who received antihypertensive treatment. Conclusion Evidence on workplace health and wellness programs in Africa is scarce. This study highlights how private sector companies can play a significant role in improving cardiovascular population health in LMICs.

Implementing a multisector public-private partnership to improve urban hypertension management in low-and middle- income countries

“…While previously, the health system could not estimate the number of people with hypertension, or monitor treatment or control rates, during our initiative health records were standardized and a first hypertension registry was created that now includes data from over 6000 patients diagnosed in 15 months. We attribute this success to optimized BP measurement opportunities, within and outside the health system, during community outreach, and in the workplace [ 24 ]. As health services for patients with chronic conditions in Dakar were almost inexistent at the start of our initiative in Dakar it is not unexpected that 86·1% of the patients were newly diagnosed during this initiative, demonstrating the high importance to accelerate detection and couple it to prompt referral into care in such settings.…”

“…framework ™ , [6] and the World Heart Federation roadmap to reduce high BP [22],as well as local guidance, policies, guidelines and data [23]. Intervention strategies varied and included: standardizing hypertension diagnosis and management at primary health level through clinical decision support systems, trainings on medical aspects, risk factors and lifestyle change, and online continuous medical education for providers, including health workers in clinics, community health workers, and pharmacists; engaging non-traditional health players such as football and samba clubs, schools, and workplaces [24] to maximize opportunities for hypertension detection and increase CV risk health literacy; and, increasing opportunities for physical exercise or healthy food options in the city [17]. Where in Brazil free treatment was available to all according to local policy, in other cities the partnership worked with local authorities to include hypertension medicines into essential drug lists.…”

Business Leadership from a Gender Perspective and Its Impact on the Work Environment and Employee’s Well-Being in Companies in the Basque Country

“…The role of workplace environments in the prevention and control of non-communicable diseases (NCDs) has been emphasized by the international community since 2012/2013, when the United Nations and World Health Organization (WHO) called for a ‘whole-of-government, whole of-society’ approach to NCDs, including the creation of an ‘enabling environment for healthy behaviors among workers’ [ 12 ].…”