Social health intervention seems to have worked wonders in 10 slums in Kochi where a group of women volunteers helped to bring about changes in the lifestyle and food habits of the people to achieve better control of hypertension.
The pilot project, taken up by the National Health Mission in association with the Kochi Corporation and Amrita Institute of Medical Sciences as part of “Unite for Healthy Ernakulam” mission, trained the women volunteers to care for groups of persons in 10 slums.
In six months, the intervention helped to improve control of hypertension among 39% of the patients compared with 21% at the start of the study which began in March 2019 and ended in September the same year.
The volunteers built such a rapport with the target groups that they could even gain entry into their kitchens and advise them on healthy ways of cooking for the family.
They also created awareness on the need for controlling blood pressure, adherence to the medical regimen, importance of diet, physical activity and the dangers of smoking.
High salt intake and poor adherence to medication were found to be a major hindrance to controlling blood pressure. The poor patients’ non-adherence to the medical regimen was due to lack of knowledge of its consequences and ignorance of their hypertension status.
Of the 4,578 persons who were the focus of the intervention, adults constituted 77% (3,521). Among those screened, 33% were new cases of hypertension.
The 43 volunteers from self help groups (SHGs) extended social and emotional support to the target groups to encourage behaviour changes and also provided linkages to primary health centres. The SHG members conducted peer group meetings every month which were attended by elected representatives as well as local opinion leaders.
Of the 231 slums in the city, 10 were chosen for the study while 10 other slums were designated as control areas where no intervention was made. The slums were chosen at random, including three in Mattancherry and Palluruthy, three in the core city areas of Thammanam, Palarivattom, and Thykoodam, and one in Thevara.
The volunteers were provided support to move into the community for a long-term management of chronic diseases.
Social intervention
The project was also a study among the population to know whether an intervention at the social level would help improve the health indices.
The women were to tackle the problem among the population where prevalence of cardiovascular diseases was reported to be the highest in Kerala with over 5,000 cases per one lakh population, and incidences of stroke were over 625 per one lakh population (studies published in Lancet Global Health ).
Studies have also shown that one in three adults in the State has hypertension with 65,600 people dying of the disorder every year.
Research strategies
Dr. Mathews Numpelil, district programme manager of the NHM, and Dr. Rakesh P.S., Public Health Intervention Specialist, and the Community Medicine Department of the Amrita Institute of Medical Sciences, devised the strategies of the research group. They highlighted the findings of the study at a press conference in the city on Tuesday.
Kochi Corporation Deputy Mayor K. R. Prem Kumar handed over the copy of the study results to District Panchayat president Dolly Kuriakose for possible replication of the work in the entire Ernakulam District Panchayat.
A copy was also handed over by District Medical Officer N.K. Kuttappan to Dr. Bipin Gopal, State Nodal Officer for Non-Communicable Diseases, for possible intervention in other parts of the State.
Shyama Rajagopal
