7.1 Incorporating community health care workers in the hypertension care model

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Strengthening primary health care for tackling the increasing burden of NCDs in Bangladesh is critically important, where the non-physician professional such as sub assistant community medical officer (SACMO), nurse and community health workers (CHW) who are based at community clinics, union-level health centers and Upazila Health Complex (UHC) could play a pivotal role in screening, provisional diagnosis, early management, referral and follow-up of patients with NCDs^57-59. Evidence shows that CHWs involvement in the delivery of primary healthcare can potentially be effective and result in cost and time savings without compromising the quality of care or health outcomes for patients^59-61. Reviewing the current evidences and suggestions of World Health Organization, the guideline committee suggests that¹⁰

• Community Health Care Workers (HCWs) may assist in tasks such as education, delivery of medications, blood pressure (BP) measurement and monitoring through an established collaborative care model.
• Telemonitoring and community-based care are encouraged to enhance the control of BP as a part of an integrated management system, when deemed appropriate by the treating medical team and found feasible and affordable by patients.
• Physician oversight can be done through telemonitoring and tele consultation to ensure access to treatment is not delayed.