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ADHINCRA (Addressing Hypertension Care in Africa) (2018 - 2021)

Uncontrolled cardiovascular disease is a leading cause of mortality in sub-Saharan Africa. The Center for Health Equity’s (CHE) “Addressing Hypertension Care in Africa” (ADHINCRA) study focuses on techniques to manage high blood pressure in western Ghana, a region where there is a shortage of physicians and nurses. The goal of the study is to explore whether blending technology, non-clinical caregivers, and culturally relevant messaging can improve outcomes in the management of high blood pressure for rural, low-income patients.  

Relying on community-based nurses trained to monitor blood pressure using protocols developed in the Baltimore-based RICH LIFE study, the ADHINCRA study seeks to apply chronic disease management interventions from health clinics to low-resource rural settings where people have non-western attitudes about health and the body. The clinical work will be supplemented by education and behavioral reinforcement techniques that are designed for the unique cultural context of sub-Saharan Africa.  

Launched in 2019, the ADHINCRA study seeks to fuse traditional African cultural values towards health and the body with technologically-advanced monitoring and motivational tools. Study participants will have access to Bluetooth-enabled blood pressure monitoring devices to record and track patient data as well as to a software app a called “Akoma pa/Empower Health.” This app will provide motivational health messages tailored for the West African culture’s notions of the body, responsibility, and wellbeing to better engage Ghanaian patients in self-care.   

Impacts: Why Is This Research Important?

Helping people manage chronic diseases helps them live more complete, fulfilling lives.  Finding effective treatment approaches helps patients and doctors make critical decisions on real-world care for high-risk patients.  Leveraging a local global learning approach, the ADHINCRA study combines approaches tested in Baltimore with new ideas in an innovative program that treats patients as whole people in specific cultural contexts, rather than just as a set of disease symptoms.  As the World Health Organization (WHO) estimates that up to 75% of deaths in Sub-Saharan Africa will be attributable to hypertension by 2020, developing interventions that can be scalable in this region has the potential of improving the well-being of millions of people. 

Who Is Involved?

The study is based at four hospitals in western Ghana:  Komfo Anokye Teaching Hospital, Kumasi South Hospital, Manhyia Government Hospital, and Suntreso Government Hospital in Kumasi, Ghana. The study will enroll a total of 240 patients for one-year periods, with six months of active intervention by the clinical team followed by six months of tracking patient progress to assess outcomes. Patients may be 18-70 years old with uncontrolled hypertension.  The study places particular emphasis on patients from low income and rural contexts.   

  • The Co-Principal Investigators are Dr. Yvonne Commodore-Mensah and Dr. Fred Stephen Sarfo 

Project Support

  • The ADHINCRA study is supported by a grant from the Johns Hopkins University Alliance for a Healthier World. 


The Center for Health Equity is proud to partner with:

  • Kwame Nkrumah University of Science & Technology (KNUST)
  • Komfo Anokye Teaching Hospital, Kumasi South Hospital
  • Manhyia Government Hospital
  • Suntreso Government Hospital

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