Design of a mobile kit for cardiovascular disease screening in resource constrained environments

Abstract

In the past few decades global health has improved significantly and many countries have started to move away from high mortality rates due to infectious diseases. This trend has however been accompanied by an increase in chronic disease incidence, in particular Cardiovascular Diseases (CVDs). In countries that are making this epidemiological transition, such as India, chronic diseases are also a hindrance to economic health as a large portion of deaths occur when people are still active in the work force. There are various policies that may be implemented to curb the burden of CVDs. These include population based approaches and high risk management strategies. In this thesis, the design of a mobile CVD Screening Kit to aid the screening of high risk subjects by low-skilled health workers is described. Focusing on India, a fertile ground where a mobile tool-kit may be implemented was identified at the intersection of: 1. Strong health worker schemes in primary care, 2. The diffusion of mobile phone technology and 3. Well developed CVD risk management strategies. The tools that constitute this CVD Screening Kit were tested at Sengupta Hospital and Research Institute, Nagpur, India. These tests showed that there is potential to develop the CVD Screening Kit further into a commercial product. The main advantage of the CVD Screening Kit developed is that, differently from standard CVD risk factor analysis, it measures the root issue of many CVDs, i.e. arterial stiffness. Therefore, the CVD Screening Kit brings complex clinical analysis capabilities, that are generally only available in equipped hospitals, to the hands of low-skilled health workers working in primary care centers. Although the CVD Screening Kit is still at an early stage of development, how it may be implemented in current public and private health programs that tackle CVDs, is also analysed in this thesis. Furthermore, it is discussed that introducing mobile phones to healthworkers, who are mostly female, may have a slow but strong impact on the independence and leadership of women.