Phone app that helps patients manage blood pressure levels

Priscilla Nduku explains how the app works at one of the patient’s home in Matiliku, Makueni County. [Stephen Nzioka, Standard]

As the world marks hypertension day today, diabetes and hypertension continue to leave many languishing in desperation.

However, there are various strides being made at various villages in Makueni County in an effort to create awareness through conducting home-based blood pressure measurements, and diabetes tests.

A 2019 World Health Organisation report on the leading causes of deaths globally showed that seven out of 10 deaths were as a result of non-communicable diseases which include diabetes and hypertension. At the village of Thumbi, Kilungu, in Makueni County, we meet Nicholas Nzioki, 44, a father of three who has been recently diagnosed with diabetes. Although he seems not distressed on medical bills by the virtue of being a civil servant where the National Hospital Insurance Fund (NHIF) takes care of most expenses, Nzioki says the journey into his long treatment freaks him out.

“I was feeling unusual and one day while I was in the church, there were people who identified themselves as Community Health Volunteers (CHVs) and wanted to do random tests for both blood pressure and diabetes. I decided to be tested and it came out true to my worries,” said Nzioki.

His diabetes is hereditary. His mother succumbed to the disease a few years ago at an advanced age.

On this particular day, Ms Winfred Mutunga, a CHV arrived at his home for weekly check-ups. She is one among many volunteers spread across Makueni villages who have been trained on digital health solution support to non-communicable disease (NCD) patients during the COVID-19 pandemic period with backing from Medtronic labs in collaboration with the Ministry of Health, PATH, and Makueni county government.

“This is an integrated locally-led solution to fighting hypertension, and diabetes through a system called 'Empower Health'. We conduct screening and the results are conveyed to the nearest health facility through a mobile phone app which captures details of that particular patient,” says Mutunga

Up the forested cold hills of Kilungu lies the homestead of Nancy Mutavi, a mother of six also recently diagnosed with diabetes. She explains that before getting diagnosed with diabetes, she experienced frequent headaches, leg pains, and cramps something that hindered her operations where she was working as a farmhand in a nearby school.

Since then, the community health workers have become routine visitors at her home to teach her how to live with the disease.

Journeys to and from hospitals due to the terrain for these patients remain an uphill task and sometimes the facilities run out of required medicines.

“Sometimes when I go to Kilungu sub-county hospital it becomes hard especially at times when crucial medicines are out of stock. I’m forced to buy over the counter which becomes a challenge. If they can test and issue medicine to us it can be easy on our side,” she pleads

Mr Alexander Mutiso, 46, a farmer,  shares Nancy's sentiments. 

He uses his farming proceeds to cater to his family's needs and buy medicine whenever they run to in the nearby health facility.

“We are tested at home, church, or elsewhere which is good as we don't have to wait in long hospital queues,” said Mr Mutiso.

Dr Patrick Kihiu, a medical officer at Kilungu sub-County hospital says every other disease has been forgotten as attention is directed to Covid-19.

“The technology makes things simpler. You get an SMS notification when your patient is not doing well and you are able to follow up remotely,” said Dr Kihiu

With the technology, Dr Kihiu says that they are able to continue managing pressure and diabetes for their patients.

When the system was operationalised in January 2021, Kilungu sub-County hospital had 120 patients under review but after the system, they are now recording 250 patients and the numbers are growing as awareness creation intensifies.

Kimilu Kimuli, 78,  a farmer and a father of 18 children has been living with diabetes and hypertension for the past 10 years. He started ailing when he was staying in Mombasa something that forced him to travel back home after the condition worsened. Through a peer educator, Priscilla Nduku, 46, also diabetic, Kimuli has been able to manage the disease.

  “I no longer take medicine for diabetes since we have managed that through diet. The medicine I have is for controlling my pressure. These tests are very close to the people and are really lifesaving,” says Kimuli.

As Kimuli listens to music over his small transistor radio, he challenges the government to accelerate efforts in fighting NCDs.

“We are filled with fear as diabetic patients. When Covid-19 is mentioned, we get disturbed because of the diseases we are currently battling. Acquiring another infection can be life-threatening,” he explains as he keeps an eye on his goats which had just returned from grazing. 

Priscilla Nduku, a mother of six, whose main task is to help people living with diabetes and hypertension access the relevant information for their continued care explained on her experiences of taking her own measurements and those of her clients.

Kimuli and his counterparts under Priscilla Nduku’s jurisdiction either make the short walk to her home for a regular check-up and getting information or she makes the visit to one’s home, like yesterday when she had just paid a visit to Kimuli.

Each reading is keyed into the mobile smartphone that links to the healthcare providers at the health centres. If the readings are not within normal, the doctors are alerted and are able to call either to give instructions on what remedial action to take or to have the patient go to the hospital

Tabitha Mulau, a clinician at Matiliku sub-county hospital says that through the technology they are able to track patients on medication and also identify the defaulters.

“All the relevant information and a historical view of the same patient are easily accessed by the healthcare workers attending to them. They are able to pick out whether one’s condition is under control early enough, and also know who is defaulting medicine to be traced back to treatment,” said Ms Mulau.

Armed with her gadget, she can easily log into the system and get in touch with patients in need of better attention, and book them to see a specialist at the facility.  

The prevalence of hypertension according to the Ministry of Health STEPS Report is said to have increased over the last 20 years. More than half (56%) of Kenyans have never measured blood pressure and only one in five (22.3%) of those previously diagnosed with hypertension are on treatment.

According to Dr Ephantus Maree, Head of Non-Communicable Diseases Department at the MOH, they are at the tail stages of planning another study on an adult population that has hypertension.

Further, 8 per cent of Kenyans have severe hypertension, and only 7 per cent of them are on medication.