Table 7

Key cost elements of standardised programme implementation: WHO Global Hearts Initiative, HEARTS technical package for CVD prevention in primary care.

HEARTS
element
DescriptionCost elements
H: Healthy lifestylesCounselling on lifestyle changes, including tobacco cessation, dietary modification, avoiding harmful use of alcohol and increasing physical activityTraining of healthcare providers
Provider time for patient screening and counselling
Health promotion materials
E: Evidence-based treatment protocolsAdopting simple, standard treatment protocols for use in primary care for the management of CVD, including secondary prevention and management of high blood pressure and diabetesProvider time for patient screening
Provider time for physical exam
Provider time for laboratory tests
A: Access to essential medicines and technologiesContinuous availability of essential medicines and basic technology in primary healthcareInventory of core medicines
Inventory of diagnostic supplies (eg, blood pressure measurement devices, laboratory supplies)
R: Risk-based ManagementIncorporating CVD risk assessment for treatment and referralTraining of healthcare providers in risk assessment
Provider time for establishing patient risk profile using risk charts
T: Team care and task sharingIncorporating team-based care and non-physician healthcare providers in primary careTraining of healthcare providers
Training of supervisors
Change in provider time across types of healthcare providers (physicians, nurses, community health workers)
S: Systems for monitoringEstablishing patient records for follow-up, tracking and reporting health outcomesTechnology (software, hardware)
Supplies (if using paper materials)
Administrative staff
Training of administrative staff
  • CVD, cardiovascular disease.