Abstract
Introduction: Hypertension, often called the “silent killer,” is a leading cause of preventable death and disability from non-communicable diseases (NCDs) worldwide. Its disproportionate burden in low- and middle-income countries highlights global health inequities, where limited access to primary care, diagnostics, and long-term management perpetuates avoidable suffering. In Ghana’s rural Savannah Region, hypertension often remains undiagnosed and uncontrolled. The Co-Produced Hypertension Adult Intervention (CO-HEART) addresses this inequity by strengthening primary health care (PHC) through a community-and provider-driven, context-specific approach.
Methods: Guided by Participatory Action Research, decolonising principles, and the Six Steps in Quality Intervention Development framework, CO-HEART engaged nurses, clinicians, district officers, and community members in co-design. The Health Belief and Socio-Ecological Models informed identification of behavioural and systemic barriers to hypertension care. Qualitative data from focus groups, interviews and workshops were analysed to co-create feasible strategies. Using APEASE criteria, the team prioritised actions that were affordable, practical, effective, acceptable, safe, and equitable.
Results: The CO-HEART intervention integrates four components: (1) community education to enhance health literacy and early detection; (2) actions to reduce barriers to hypertension care; (3) improved quality service delivery through community nurse capacity-building; and (4) coordination with district health authorities to embed hypertension care in PHC services. Early outcomes show improved screening, referral adherence, nurse-directed care, and stronger collaboration across care levels.
Discussion: CO-HEART demonstrates how co-production, capacity building and nurse-directed care can advance health equity by decentralising chronic disease care in resource-limited settings. Embedding the CO-HEART within existing PHC structures promotes sustainability and aligns with WHO’s call for equitable, people-centred NCD care and SDG 3.4 to reduce premature NCD deaths by 2030. By framing hypertension as both a medical and moral imperative, CO-HEART shows that tackling this silent killer requires ethical, inclusive, and locally led action that turns global goals into local impact.
Notes
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Sigma Membership
Lambda Pi at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Sustainable Development Goals, Health Equity or Social Determinants of Health, Primary Care, Hypertension, Ghana, Hypertension--Ghana, Rural Areas
Recommended Citation
Peniston, Sandra, "Advancing Global Health Equity Through Co-Produced Hypertension Care in Rural Ghana" (2026). International Nursing Research Congress (INRC). 64.
https://www.sigmarepository.org/inrc/2026/presentations_2026/64
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-26
Advancing Global Health Equity Through Co-Produced Hypertension Care in Rural Ghana
Toronto, Ontario, Canada
Introduction: Hypertension, often called the “silent killer,” is a leading cause of preventable death and disability from non-communicable diseases (NCDs) worldwide. Its disproportionate burden in low- and middle-income countries highlights global health inequities, where limited access to primary care, diagnostics, and long-term management perpetuates avoidable suffering. In Ghana’s rural Savannah Region, hypertension often remains undiagnosed and uncontrolled. The Co-Produced Hypertension Adult Intervention (CO-HEART) addresses this inequity by strengthening primary health care (PHC) through a community-and provider-driven, context-specific approach.
Methods: Guided by Participatory Action Research, decolonising principles, and the Six Steps in Quality Intervention Development framework, CO-HEART engaged nurses, clinicians, district officers, and community members in co-design. The Health Belief and Socio-Ecological Models informed identification of behavioural and systemic barriers to hypertension care. Qualitative data from focus groups, interviews and workshops were analysed to co-create feasible strategies. Using APEASE criteria, the team prioritised actions that were affordable, practical, effective, acceptable, safe, and equitable.
Results: The CO-HEART intervention integrates four components: (1) community education to enhance health literacy and early detection; (2) actions to reduce barriers to hypertension care; (3) improved quality service delivery through community nurse capacity-building; and (4) coordination with district health authorities to embed hypertension care in PHC services. Early outcomes show improved screening, referral adherence, nurse-directed care, and stronger collaboration across care levels.
Discussion: CO-HEART demonstrates how co-production, capacity building and nurse-directed care can advance health equity by decentralising chronic disease care in resource-limited settings. Embedding the CO-HEART within existing PHC structures promotes sustainability and aligns with WHO’s call for equitable, people-centred NCD care and SDG 3.4 to reduce premature NCD deaths by 2030. By framing hypertension as both a medical and moral imperative, CO-HEART shows that tackling this silent killer requires ethical, inclusive, and locally led action that turns global goals into local impact.
Description
CO-HEART is a co-produced hypertension intervention in rural Ghana that strengthens primary health care through a community and provider co-design approach. Guided by Participatory Action Research and decolonising principles, it applies the Health Belief and Socio-Ecological Models to address behavioural and systemic barriers. The intervention enhances screening, adherence, and nurse-led care while advancing equity, sustainability, and global goals.