The NCD Study was a two-year implementation research project led by Help REACH Africa (HERA) in partnership with Yale University School of Nursing and Nairobi County Government.
The study sought to identify barriers and facilitators to screening and management of hypertension and type 2 diabetes among residents of informal settlements in Nairobi. The research focused on understanding challenges faced by patients, healthcare providers, and community health systems, and identifying practical solutions to improve prevention, early diagnosis, and management of non-communicable diseases (NCDs).
The study was implemented in Huruma Lions Health Centre and Kariobangi North Health Centre and utilized community-centered approaches to generate evidence and strengthen local capacity.
- Identify barriers and facilitators to screening and management of hypertension and type 2 diabetes
- Understand community, health system, and individual-level factors influencing NCD care
- Engage stakeholders in developing locally relevant implementation strategies
- Strengthen capacity of community health teams in NCD prevention and management
- Generate evidence to inform policy and programmatic interventions
Key Results
- Conducted 38 in-depth interviews with healthcare providers, community health workers, patients, and community stakeholders
- Administered 72 food frequency questionnaires and 10 WHO NCD surveys
- Completed three Evidence-Based Quality Improvement (EBQI) meetings involving healthcare providers, county leadership, community representatives, and patients
- Identified practical and locally relevant strategies for improving NCD screening and management
- Trained 21 Community Health Assistants (CHAs) and 11 Community Health Promoters (CHPs) on hypertension and type 2 diabetes screening and management
- Achieved 100% participant enrollment, attendance, and retention during the pilot intervention
- Demonstrated significant improvement in participant knowledge, confidence, communication, and leadership skills following the training
- Generated evidence to support community-based NCD prevention and management approaches
The study was implemented in three phases.
Phase I: Understanding Barriers and Facilitators
Researchers conducted surveys, interviews, and community assessments to understand challenges affecting NCD screening and management in informal settlements.
Phase II: Stakeholder Engagement and Strategy Development
Findings from Phase I were shared through Evidence-Based Quality Improvement (EBQI) meetings that brought together patients, healthcare workers, county leadership, community organizations, and health managers to identify practical solutions.
Phase III: Capacity Building Pilot Intervention
Based on recommendations from stakeholders, HERA implemented a pilot intervention focused on strengthening the capacity of Community Health Assistants and Community Health Promoters to support NCD screening, referral, and management at the community level.
One of the most significant findings from the study was the critical role played by community health teams in improving access to NCD services.
During stakeholder consultations, participants consistently highlighted the need for better training and support for community health workers who often serve as the first point of contact for individuals living with hypertension and type 2 diabetes.
In response, HERA and Yale University designed and implemented a three-day NCD training workshop that equipped Community Health Assistants and Community Health Promoters with knowledge and skills on NCD screening, management, communication, and leadership.
The training resulted in improved knowledge, increased confidence, and stronger capacity among participants to support community-based prevention and management of hypertension and type 2 diabetes.
The study was implemented in:
- Mathare Sub-County, Nairobi County
- Huruma Lions Health Centre
- Kariobangi North Health Centr
Donor
- Yale University School of Nursing
Partners
- Nairobi County Government
- Ministry of Health
- Community Health Teams
- Huruma Lions Health Centre
- Kariobangi North Health Centre
Completed
The project was successfully completed in December 2024.
Findings from the study continue to support advocacy, policy discussions, community health strengthening, and evidence-based approaches for improving NCD prevention and management in Kenya.
HERA is working with researchers and partners to support dissemination, publication, and application of the study findings.
