“Combating Chronic Diseases in India using Community Health Workers”
Bangalore, Karnataka, India
St. John's Research Institute
Tanvir Hussain, MD, MSc
Blog 1: Project Background
On May 3, I returned to St. John’s Research Institute in Bangalore to continue working on the SPREAD Project. The SPREAD project (Secondary Prevention of coronary Events After Discharge from hospital) is a randomized controlled trial in secondary prevention of acute coronary syndrome developed to serve the urban slums and rural village populations. The design is an open trial comparing post-discharge interventions delivered by community health workers to standard care in 10 secondary and tertiary care hospitals. The objectives at the outset were to assess feasibility, estimate rates of adherence to pharmacotherapy, assess adherence to lifestyle modification, and obtain an estimate of the event rates in an Indian setting.
SPREAD is an example of the response to changing disease burden globally. As developing countries undergo epidemiologic transition and disease burden shifts from communicable disease towards chronic illnesses, current health delivery systems are being recognized as inadequate to manage CAD, DM, COPD, and cancer in low and middle income countries. In 2009, the NIH provided funding to medical institutions in developing countries to implement innovative strategies in chronic disease care. In India, where CVD is the leading cause of mortality in the urban and rural population, St. John's Institute of Bangalore is pioneering a community health worker (CHW) based secondary prevention model for CAD, the "SPREAD" project.