Impact observed from 2023 - 2026

Noncommunicable diseases (NCDs), particularly cardiovascular diseases, are a leading cause of death worldwide, with the highest burden in the African region. Hypertension poses life-threatening challenges to adults in Rwanda, where nearly 28% of people over 45 have been diagnosed, yet only 10% of those diagnosed receive treatment. Nyamasheke District, one of Rwanda’s largest districts with approximately half a million residents, reports the highest number of hypertensive patients.

In 2023, public health professionals in Rwanda convened for the Data to Policy (D2P) Program to assess and address a range of public health problems across the country. One group, including Valens Ndagijimana, Sincere Josue Ukuri and Patrick Uwiduhaye, applied their diverse expertise in mortality surveillance data management, cardiovascular diseases and health promotion to understand the root causes of the high burden of hypertension in Nyamasheke District. They found that healthcare providers maintained low participation in refresher courses and were incompliant with NCD guidelines. The group also discovered that poor medication adherence and inadequate follow-up was largely due to widespread lack of community knowledge of hypertension, its risk factors and prevention strategies.

The D2P group developed a policy brief that proposed interventions to improve the management of hypertension by two means: 1) through online learning for healthcare workers to advance their knowledge of hypertension diagnosis and management, and 2) by engaging NCD ambassadors, or peer educators, to support fellow patients with hypertension. Rwanda Biomedical Centre (RBC) adopted the policy, and the Non-Communicable Diseases Division and Bushenge Provincial Hospital have implemented it over the last three years in Nyamasheke District.

As a result, healthcare providers are now identifying cases of hypertension and diabetes earlier. They are better supporting patients to manage disease and prevent related complications.

Additionally, the NCD ambassador program has grown to include 12 peer support groups for patients with hypertension in Nyamasheke District. Each group consists of approximately 30 patients and is supported by one NCD peer educator, resulting in an estimated reach of around 360 hypertensive patients in Nyamasheke. Similar peer-support programs are also underway in Musanze, a city in the northwest of Rwanda.