Lifestyle-related disease is on the rise in South Africa, including high blood pressure. An ingenious partnership involving Oxford University is putting the nation’s extensive mobile phone network to work in beating the disease.
Out in the townships of South Africa’s Western Cape, unemployment can run at 44 per cent. Entire households may depend on a single old age pension for food. Gang violence leaves people wary of being robbed on the way to a clinic appointment.
With life so chaotic and stressful for many, remembering to take your hypertension medication may seem like a small side issue. But while HIV and TB are epidemic in many communities, there is also a creeping rise in chronic lifestyle diseases. These include hypertension, now the leading cause of death and disability worldwide. According to the South African Medical Research Council, 6.2 million people in a population of 52 million have high blood pressure and 3.2 million have unacceptably high levels, heightening the risk of heart attacks and strokes.
Inequity in South Africa’s health care is high. Many people in the areas surrounding towns and cities can’t get to the care that they need. Those patients that do attend often have problems taking tablets or forget to take them or abandon their medication once they start to feel a little better. Many patients don’t like sitting and waiting in clinics, while information leaflets about adherence to a treatment course are often unread. Some simply drop out of the care system.
Since 2009, Oxford Professor of General Practice in the Nuffield Department of Primary Care Health Sciences Andrew Farmer, in collaboration with Professor of Endocrinology and Diabetes at the University of Cape Town and head of the Chronic Disease Initiative for Africa (CDIA) Naomi Levitt, and epidemiologist and medical doctor Kirsty Bobrow have been working together on innovative solutions to these challenges.
The SMS-Adherance Support Trial (StAR) is a partnership involving Oxford, the CDIA and the University of Cape Town (UCT) and the South African Medical Research Council (SAMRC). In Oxford it brings together the Nuffield Department of Primary Care Health Sciences with the Department of Biomedical Engineering, and is funded by the Wellcome Trust and the Engineering and Physical Sciences Research Council.