Andhra Pradesh Rural Health Initiative - APRHI

Aims

conducting an interview

Implementing affordable and sustainable interventions in rural Indian health care is one aim of APHRI

The APRHI Collaboration works to:

  • 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:

  1. a mortality surveillance system
  2. disease and risk factor prevalence surveys
  3. a quantitative and qualitative assessment of health services
  4. 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

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20 villages participated in the APRHI survey

The mortality surveillance system based on verbal autopsy has been in place since October 2003 in 45 villages. Coding of causes of death has generated useful data reflecting the epidemiologic transitions occurring in rural India.

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:

  1. A high risk strategy using an algorithm to identify and manage individuals at high cardiovascular risk
  2. 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

Collaboration

Funding Agencies