World Heart Podcast

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Mr. Girma Dessie

Country Director, Ethiopia, Resolve to Save Lives

Dr. Andrew Moran

Editor, Global Heart | Associate Professor, Columbia University | Chief of Cardiovascular Health Science, Resolve to Save Lives

In this episode of the Global Heart Podcast, host Pablo Perel speaks with Mr. Girma Dessie and Dr. Andrew Moran about a study conducted in Ethiopia examining hypertension follow-up in the HEARTS cardiovascular care program. They explore how implementation science, despite disruptions like COVID-19 and civil conflict, led to concrete health system reforms and improved access to care. The discussion also introduces a new Global Heart journal section—Lessons from the Field—highlighting evidence-based innovation, digital health tools, and health equity strategies in low- and middle-income countries.

The Ethiopian case study demonstrates how operational research in noncommunicable diseases (NCDs)can drive policy change, support universal health coverage, and improve care for people living with chronic conditions like hypertension.

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Key Takeaways:

Real-World Evidence from Ethiopia

• Ethiopia’s HEARTS hypertension program, co-led by the Ministry of Health and Resolve to Save Lives, showed strong initial uptake but experienced high patient loss to follow-up (~33%).

• Digital tracking tools revealed patterns in missed appointments, prompting an operational research study to identify key barriers.

Research Design Amid Disruption

• The study originally planned as a pre/post intervention trial had to pivot to a cross-sectional design due to the COVID-19 pandemic and ongoing civil unrest.

• Data was collected from over 1,100 patients across 32 primary health care sites using structured questionnaires and logistic regression analysis.

Barriers to Continuity of Care

• The top three factors associated with missed follow-up visits were:

  • Financial barriers (transport costs, out-of-pocket medication expenses)

  • Travel time (patients traveling over one hour more likely to miss care)

  • Poor appointment scheduling and communication

Impact on Policy and Practice

• The study prompted:

  • Expansion of community-based health insurance to reduce out-of-pocket costs.

  • Adoption of differentiated service delivery models (e.g., 3-month medication refill for stable patients).

  • Policy reforms to decentralize hypertension care to the community level.

Launching ‘Lessons from the Field’

• Global Heart has introduced a new article series to support frontline researchers and practitioners in low-resource settings.

• These brief reports aim to elevate the visibility of operational and implementation research that may otherwise remain unpublished.

The Role of Research in Advocacy

• Implementation research not only improves care delivery but also serves as a key tool for policy change, particularly when embedded in ongoing health programs.

Stay Informed and Take Action

Read the featured paper in Global Heart:
Factors Associated with Hypertension Care Follow-Up in the Ethiopia HEARTS Program

Together, we can bridge the gap between knowledge and practice to create a healthier world!