The Female Community Health Volunteers (FCHVs) can play a vital role in fighting non-communicable diseases in Nepal, a new study says.

The FCHVs in Nepal earned accolades for their contribution in the country’s health sector.

A latest study published in Lancet Global Health shows that lifestyle interventions led by the FCHVs can be effective for the reduction of high blood pressure in the general population of Nepal.

Estimations in Nepal show that one in four adults have high blood pressure, and approximately half of them do not know they have it.

The study titled “Effectiveness of a Lifestyle Intervention led by Female Community Health Volunteers versus Usual Care In Blood Pressure Reduction (COBIN): an Open-Label, Cluster-Randomised Trial,” showed that visits by the FCHVs to disseminate health promotion messages and screen blood pressure led to a significant reduction of blood pressure.

Dinesh Neupane, principal investigator of the study, said, “We now have evidence showing the crucial role of FCHVs in reducing blood pressure.”

The publication is based on Neupane’s research for a PhD from the Aarhus University, Denmark. Neupane is now associated with the Global Health Research Center as a post-doctoral fellow at the Duke Kunshan University, Kunshan, China. 

According to Neupane, previous studies have established that even a small drop in blood pressure at the population level is beneficial for reducing cardiovascular disease events and mortality. “For example previous studies have estimated that even a marginal reduction in blood pressure could reduce stroke mortality by 14 percent of coronary heart disease mortality by 9 percent and of all-cause mortality by 7 percent,” said Neupane. “The results of this study provide proof of concept. There is now the potential to scale up and replicate this intervention programme in other developing countries.”

Neupane stressed that given the increasing burden of NCDs in Nepal, it has to make use of its pool of over 50,000 FCHVs to help in curbing the incidence of NCDs.

The study was conducted between April 1, 2015 and Dec 31, 2015 where 1638 (939 assigned to intervention; 699 assigned to control) participants were recruited. In the course of the study, 43 FCHVs, who were thoroughly trained by researchers, had visited the households three times a year in every four months to provide health promotion counselling and measure blood pressure.

The study states that during the visits, the FCHVs delivered the lifestyle counselling intervention, focusing on increasing physical activity, lowering salt consumption, reducing alcohol consumption, avoiding smoking and decreasing stress. If participants had high blood pressure, they were referred to the nearest health facility and, if the respondents were already taking medications, they were also followed up for adherence to their medication during the FCHV visit.

Dr Arjun Karki, senior physician and co-author of the study, said while the study has some exciting findings, further study should be carried out for improving the length of follow-up of the individuals, as well as assessing the sustainability of the intervention.