title: Building Sustainable Capacity for Cardiovascular Care at a Public Hospital in Western Kenya.
abstract: Cardiovascular disease deaths are increasing in low- and middle-income countries and are exacerbated by health care systems that are ill-equipped to manage chronic diseases. Global health partnerships, which have stemmed the tide of infectious diseases in low- and middle-income countries, can be similarly applied to address cardiovascular diseases. In this review, we present the experiences of an academic partnership between North American and Kenyan medical centers to improve cardiovascular health in a national public referral hospital. We highlight our stepwise approach to developing sustainable cardiovascular services using the health system strengthening World Health Organization Framework for Action. The building blocks of this framework (leadership and governance, health workforce, health service delivery, health financing, access to essential medicines, and health information system) guided our comprehensive and sustainable approach to delivering subspecialty care in a resource-limited setting. Our experiences may guide the development of similar collaborations in other settings.
authors.affiliation: Duke Clinical Research Institute, Duke University, Durham, North Carolina; Hubert Yeargan Center for Global Health, Duke University, Durham, North Carolina.
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Binanay
authors.affiliation: Moi Teaching and Referral Hospital, Eldoret, Kenya.
authors.forename: Constantine O
authors.initials: CO
authors.lastname: Akwanalo
authors.affiliation: Moi Teaching and Referral Hospital, Eldoret, Kenya.
authors.forename: Wilson
authors.initials: W
authors.lastname: Aruasa
authors.affiliation: Moi Teaching and Referral Hospital, Eldoret, Kenya.
authors.forename: Felix A
authors.initials: FA
authors.lastname: Barasa
authors.affiliation: Duke Clinical Research Institute, Duke University, Durham, North Carolina; Hubert Yeargan Center for Global Health, Duke University, Durham, North Carolina; Duke University Medical Center, Durham, North Carolina; Duke Global Health Institute, Duke University, Durham, North Carolina.
authors.forename: G Ralph
authors.initials: GR
authors.lastname: Corey
authors.affiliation: Purdue University College of Pharmacy, West Lafayette, Indiana.
authors.forename: Susie
authors.initials: S
authors.lastname: Crowe
authors.affiliation: College of Health Sciences, Moi University, Eldoret, Kenya.
authors.forename: Fabian
authors.initials: F
authors.lastname: Esamai
authors.affiliation: Indiana University, Indianapolis, Indiana.
authors.forename: Robert
authors.initials: R
authors.lastname: Einterz
authors.affiliation: Duke University Medical Center, Durham, North Carolina.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Foster
authors.affiliation: Indiana University, Indianapolis, Indiana.
authors.forename: Adrian
authors.initials: A
authors.lastname: Gardner
authors.affiliation: Moi Teaching and Referral Hospital, Eldoret, Kenya.
authors.forename: John
authors.initials: J
authors.lastname: Kibosia
authors.affiliation: Moi Teaching and Referral Hospital, Eldoret, Kenya; College of Health Sciences, Moi University, Eldoret, Kenya.
authors.forename: Sylvester
authors.initials: S
authors.lastname: Kimaiyo
authors.affiliation: Moi Teaching and Referral Hospital, Eldoret, Kenya.
authors.forename: Myra
authors.initials: M
authors.lastname: Koech
authors.affiliation: Hubert Yeargan Center for Global Health, Duke University, Durham, North Carolina.
authors.forename: Belinda
authors.initials: B
authors.lastname: Korir
authors.affiliation: Hubert Yeargan Center for Global Health, Duke University, Durham, North Carolina; Duke University Medical Center, Durham, North Carolina.
authors.forename: John E
authors.initials: JE
authors.lastname: Lawrence
authors.affiliation: Purdue University College of Pharmacy, West Lafayette, Indiana.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lukas
authors.affiliation: Moi Teaching and Referral Hospital, Eldoret, Kenya.
authors.forename: Imran
authors.initials: I
authors.lastname: Manji
authors.affiliation: Moi Teaching and Referral Hospital, Eldoret, Kenya.
authors.forename: Peris
authors.initials: P
authors.lastname: Maritim
authors.affiliation: Moi Teaching and Referral Hospital, Eldoret, Kenya.
authors.forename: Francis
authors.initials: F
authors.lastname: Ogaro
authors.affiliation: Hubert Yeargan Center for Global Health, Duke University, Durham, North Carolina; Indiana University, Indianapolis, Indiana.
authors.forename: Peter
authors.initials: P
authors.lastname: Park
authors.affiliation: Purdue University College of Pharmacy, West Lafayette, Indiana.
authors.forename: Sonak D
authors.initials: SD
authors.lastname: Pastakia
authors.affiliation: Moi Teaching and Referral Hospital, Eldoret, Kenya.
authors.forename: Wilson
authors.initials: W
authors.lastname: Sugut
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Vedanthan
authors.affiliation: Moi Teaching and Referral Hospital, Eldoret, Kenya.
authors.forename: Reuben
authors.initials: R
authors.lastname: Yanoh
authors.affiliation: Duke Clinical Research Institute, Duke University, Durham, North Carolina; Duke University Medical Center, Durham, North Carolina; Duke Global Health Institute, Duke University, Durham, North Carolina.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Velazquez
authors.affiliation: Duke Clinical Research Institute, Duke University, Durham, North Carolina; Duke University Medical Center, Durham, North Carolina; Duke Global Health Institute, Duke University, Durham, North Carolina. Electronic address: gerald.bloomfield@duke.edu.
authors.forename: Gerald S
authors.initials: GS
authors.lastname: Bloomfield
mesh_terms: D057191:Capacity Building; D002300:Cardiac Care Facilities / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000458:organization & administration*; D006779:Hospitals, Public / Q000458:organization & administration*; D006801:Humans; D007630:Kenya; D016730:Program Development
keywords: cardiovascular disease; global health partnership; limited resources; sub-Saharan Africa