Cardiovascular diseases are the leading cause of deaths and disability in many low-and middle-income countries, including Nepal. Prevention of cardiovascular diseases demands innovative solutions through multidisciplinary and multifaceted approaches. With a nearly 100% mobile phone ownership rate in the country, Nepal’s Ministry of Health has prioritized mobile health (mHealth) interventions. Medic Mobile has received support to scale up its feature-phone-based (non-smartphone) program to thousands of female community health volunteers to address prenatal care and maternal health. This Bass Connections project collaborated with these partners to develop design insights and feature-phone-based programs, with the goal to create a foundation for interventions with the potential to make a significant impact on hypertension prevention and control.

The goal of this project was to establish a dynamic collaboration among students of different levels in two Duke campuses and faculty from diverse disciplines for developing a low-cost, user-centered digital solution to reduce blood pressure among hypertensive patients in rural Nepal. The project team conducted interviews with female community health volunteers, patients and policy actors to understand workflows, needs and challenges around hypertension care coordination in Nepal, including access and adherence barriers.

Team members prepared a detailed feasibility, design and technical specification report (including final mHealth workflow sketches) and beta feature-phone-based programs. Medic Mobile provided guidance and feedback to the team. Development of the beta version was led by start-up company Laohan. Finally, the team organized a roundtable discussion in Kathmandu, Nepal, attended by more than 20 attendees from academic and industry institutions in the United States, China and Nepal. The aim was to improve primary care service delivery for noncommunicable diseases (especially hypertension and diabetes) in rural and urban Nepal and generate new ideas for collaborative projects and partnerships.

Timing

Summer 2018 – Spring 2019  

Team Outputs

Zhao Ni, Namratha Atluri, Ryan J. Shaw, Jingru Tan, Kinza Khan, Helena Merk, Yunfan Ge, Shrinkhala Shrestha, Abha Shrestha, Lavanya Vasudevan, Biraj Karmacharya, Lijing L. Yan. 2020. “Evaluating the feasibility and acceptability of a mobile health-based female community health volunteer program for hypertension control in rural Nepal: Cross-sectional study,” JMIR mHealth and uHealth 8(3):e15419.

Jingru Tan, Hanzhang Xu, Olivia Neely, Rinchen Doman, Rishika Gundi, Binjwala Shrestha, Abha Shrestha, Wanbing Gu, Truls Ostbye, Lijing Yan. YEAR. A Qualitative Study of Current Hypertension Care Coordination and Feasibility of Involving Female Community Health Volunteers in Hypertension Management in Kavre District, Nepal. Submitted paper.

Zhao Ni, Olivia Neely, Rinchen Doma, Rishika Gundi, Sweta Kafle, Kinza Khan, Namratha Atluri. Extending the Role of Female Community Health Volunteers in Nepal to Hypertension Prevention and Control. Paper in development. 

Developing a Feature-Phone Based Female Community Health Volunteer Program for Hypertension Control in Rural Nepal: Assessment Phase (poster by Zhao Ni, Sweta Kafle, Jingru Tan, Rinchen Doma, Rishika Gundi, Namratha Atluri, Olivia Neely, Yunfan Ge, Helena Merk, Kinza Khan, Wanbing Gu, Ryan Shaw, Lijing Yan, presented at Bass Connections Showcase, Duke University, April 17, 2019)

Developing A Feature-Phone Based Female Community Health Volunteer Program for Hypertension Control in Rural Nepal: Assessment Phase (poster by Zhao Ni, Sweta Kafle, Jingru Tan, Rinchen Doma, Rishika Gundi, Namratha Atluri, Olivia Neely, Yunfan Ge, Helena Merk, Kinza Khan, Wanbing Gu, Ryan Shaw, Lijing Yan, presented at Global Health Research Showcase, Duke University, November 5, 2018)

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