A community-based health insurance program in sub-Saharan Africa helps reduce the risk of heart disease and stroke
AMSTERDAM – February 21, 2014
High blood pressure is now the leading risk factor for death in sub-Saharan Africa. A new study demonstrates that improved access to health care through health insurance can lower high blood pressure, which contributes to reduced risk of cardiovascular disease.
The study, Effect of Health Insurance and Facility Quality Improvement on Blood Pressure in Adults with Hypertension in Nigeria: A Population-Based Study, assessed the effect of a community-based health insurance program on blood pressure in adults with hypertension in rural Nigeria. As reported in JAMA Internal Medicine, the research showed that a community-based health insurance program that increased access to health care is associated with a significant decrease in blood pressure in patients diagnosed with hypertension.
Patients with hypertension who participated in the insurance program had a 5 mmHg decrease in systolic blood pressure over a period of 24 months. This is an important reduction given that the World Health Organization (WHO) estimates that a 10 mmHg reduction in systolic blood pressure at the population level reduces the risk of stroke by 38% and the risk of ischemic heart disease by 26%.
"We are encouraged by these results: systolic blood pressure fell significantly more in the community with health insurance than in a control community. If we can bring down blood pressure, we can reduce the risk of stroke and heart attacks”, says first author Marleen Hendriks of the Amsterdam Institute for Global Health and Development (AIGHD).
The study evaluated the impact of Hygeia Community Health Care in Kwara State, Nigeria. Established in 2007, the health care plan is a joint initiative of the Dutch organizations PharmAccess and Health Insurance Fund, the Nigerian insurance company Hygeia, and the Kwara State Government to make quality health care accessible for the rural poor of Kwara. The health insurance package offered through Hygeia Community Health Care covers the cost of antihypertensive treatment.
Professor Tanimola M. Akande, co-author of the study and Professor of Public Health at the University of Ilorin, says, “The health plan has had a dramatic effect on people in the region. Health facilities have been able to improve the quality of their services and many people are now able to visit healthcare facilities when they need to. Before, they either couldn’t afford to go or they didn’t know they needed treatment. Kwara has a high incidence of non-communicable diseases such as cardiovascular disease and of modifiable risk factors such as hypertension and diabetes.”
Coverage of anti-hypertensive treatment remains low throughout the region. Community-based health insurance not only provides access to health care to low-income populations but can help to prevent further poverty and improve health outcomes. This study supports the inclusion of community-based health insurance programs in strategies to combat cardiovascular disease in sub-Saharan Africa.
The study was supported by the Health Insurance Fund.
JAMA Internal Medicine, February 2014, Vol 174, No. 2, https://archinte.jamanetwork.com/article.aspx?articleid=1830020
Director of Public Affairs
The Amsterdam Institute for Global Health and Development (AIGHD)
AIGHD is an academic collaboration between the Academic Medical Center, the University of Amsterdam, the VU University of Amsterdam, and non-governmental organizations. AIGHD links disciplines, resources, and innovative programs from academic institutions and implementing partners in both the developed and developing world, with the ultimate aim to lead the way to access to high quality health care for all inhabitants of this world. It aims to provide sustainable solutions to major health problems across our planet, by forging synergies between disciplines, health care delivery, research, and education.