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Strengthening the Heart of a Community in Thailand

Posted on by Henry Vandi

Henry Vandi is a CDC Foundation field employee in the Division of Global Health Protection in CDC’s Center for Global Health

Henry Vandi is a health scientist in the Division of Global Health Protection in CDC’s Center for Global Health.

As we approached a house surrounded by lush, tropical vegetation, a petite but muscular woman with a warm smile greeted us on the porch. “Hello! I’ve been waiting for you!” Sampaow said cheerfully, wrapping her arms around Monsasiporn. As Monsasiporn and Sampaow settled at a table outside, they spoke excitedly like old friends.

I am a CDC Foundation field employee visiting a small community two hours north of Bangkok, Thailand with Monsasiporn, a village health volunteer for the Thai Global Hearts Project.

The Thai Global Hearts Project is a one-year pilot program that aims to decrease heart disease and stroke by improving blood pressure control, ensuring people follow treatment advice, and increasing healthy lifestyle choices. A CDC colleague and I were invited by Thailand’s Ministry of Public Health (MOPH) and the CDC Thailand country office to provide technical guidance on data collection and analysis.

Today Monsasiporn is visiting Sampaow and three other project participants. Along with another volunteer, Monsasiporn checks on nine project participants each month. Village health volunteers provide monthly support, coaching, and education on monitoring blood pressure, tracking medications, maintaining consistent care with providers, and reducing salt intake.

Understanding Healthy Choices

“I wanted to improve health in villages similar to my own,” Monsasiporn explained when asked about why she became a village health volunteer, “with this project, I can help people understand their health and what it means to make healthy choices.”

Village health volunteers participating in the program received training from the program team on hypertension, health promotion, and motivational interviewing.

“When we first started the project, people didn’t understand why their blood pressure mattered, why they needed to take medication or make lifestyle changes when they felt fine. It was just something their doctor told them to do, but they didn’t really get it, so they quickly lost motivation,” Monsasiporn continued.

Primary care doctors in Thailand are extremely busy. However, village health volunteers come from surrounding villages and visit the patients seven times each month. “We can take the time to connect with the patient, explain what their blood pressure numbers mean, and what they can do to improve their health in a way that patients understand.”

The chief of the district hospital in Sampaow’s district provides updates on the Thai Global Hearts Project and checks in with village health volunteers prior to the home visits. Photo credit: Henry Vandi
The chief of the district hospital in Sampaow’s district provides updates on the Thai Global Hearts Project and checks in with village health volunteers prior to the home visits. Photo credit: Henry Vandi

Seeing Change Firsthand

When the village health volunteers began their visits, most patients were not tracking their blood pressure. “Talking with patients, we realized they didn’t understand how to take their own measurements and found the tracking forms confusing,” Monsasiporn explained.

So the village health volunteers worked with the project team to provide training and simplify the forms. Once patients were able to measure their own blood pressure and track their data, they began to see the benefits of medication and lifestyle changes on lowering their blood pressure.

“None of our other projects have provided this type of frequent, village health volunteer-supported monitoring before,” commented Dr. Sasamon Srisuthisak, the MOPH’s technical coordinator on the project, “yet it’s proving to be one of the key factors in keeping participants motivated. The home visits and self-monitoring seem to help volunteers, health workers, and patients maintain momentum in this journey toward better community health.”

The MOPH launched the pilot in March 2019. Once complete in March 2020, data from Sampaow’s village will be compared to data from a comparable village not participating in the program. CDC provides support and technical guidance on the program design, data collection, and data analysis.

While formal data for the initiative is not yet available, the project is already showing positive impacts.

Sampaow discusses her blood pressure reading with Monsasiporn and describes challenges she has been facing with self-monitoring. Photo credit: Henry Vandi
Sampaow discusses her blood pressure reading with Monsasiporn and describes challenges she has been facing with self-monitoring. Photo credit: Henry Vandi

Spreading Community Support

As we visited project participants, I was impressed by the incredible community ownership for the project, which seemed to lead to community members feeling increased ownership of their own health.

Sitting on the porch with Sampaow, an elderly neighbor approached. “Oh, blood pressure time!” he exclaimed. “I want my blood pressure checked too!” While not a program participant, Sampaow’s neighbor has become interested in tracking his blood pressure numbers as well.

“We’ve been astounded by the level of support we’ve seen in just the past few months. An intervention like this could not be successful without community participation,” said Dr. Srisuthisak. “The incredible support from the local government—both health and non-health sectors, the village health volunteers, and the community has certainly been a testament to the potential feasibility of scaling up this project.”

If the pilot is successful, the MOPH will likely expand the initiative to additional communities and hopefully make it nationwide in a few years.

Related Links:
WHO Global Hearts Initiative

WHO Hearts Technical Package

Thai Global Hearts Project Keeps Communities Heart-Healthy (World Heart Day 2018 story)

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