Andhra Pradesh Rural Health Initiative - APRHI
Aims
Implementing affordable and sustainable interventions in rural Indian health care is one aim of APHRI
- improve health status
- prevent and manage non-communicable disease
- prevent premature death, and
- enhance access to health services
for the people of rural Andhra Pradesh.
We aim to achieve this through the design, implementation and evaluation of affordable and sustainable interventions that can be incorporated in the existing primary health care infrastructure of rural areas.
Methods
Priority interventions will be proposed based on evidence from the following activities:
- a mortality surveillance system
- disease and risk factor prevalence surveys
- a quantitative and qualitative assessment of health services
- low cost, evidence-based health interventions to address priority issues
Capacity building, including institutional strengthening and academic training, is integral to all projects.
Status/Results
20 villages participated in the APRHI survey
A pilot of the disease and risk factors prevalence survey was conducted among 345 randomly selected residents of two villages. Analysis suggested that communities were likely to benefit from a cardiovascular disease prevention program.
A large scale survey of 4,535 adults in 20 villages in rural Andhra Pradesh was completed in early 2005 and provided more accurate estimates of risk factors and prevalence levels of cardiovascular diseases and injury. This survey formed the baseline for RAPCAPS (Rural Andhra Pradesh Cardiovascular Prevention Study).
The cardiovascular disease prevention program comprises of two strategies:
- A high risk strategy using an algorithm to identify and manage individuals at high cardiovascular risk
- A population based health promotion campaign designed to improve the population’s knowledge of cardiovascular disease
Implementation via a cluster randomised trial in 44 villages has commenced in 2006 following findings from the survey and the mortality surveillance system. The prevention program is currently being evaluated and will be reported in 2008.
Institute Investigators
- Bruce Neal
- Rohina Joshi
- Clara Chow
- Rebecca Ivers
- Robyn Norton
- Stephen MacMahon
- Mark Stevenson
Collaboration
- Byrraju Foundation, Hyderabad, India
- CARE Foundation, Hyderabad, India
- Centre for Chronic Disease Control, New Delhi, India
- School of Population Health, University of Queensland, Brisbane, Australia
Funding Agencies
- The George Foundation
- Byrraju Foundation (India)
- Australian Government Department of Education, Science and Training
- The National Heart Foundation of Australia
- Royal Australasian College of Physicians
- International Development Fund, University of Sydney
- NHMRC Equipment Grant
- University of Sydney
- Initiative for Cardiovascular Health Research in Developing Countries (IC Health)
- UK Wellcome Trust
- Future Forum