Cabo Verde is reinforcing its primary health care system implementing the World Health Organization (WHO) package of essential noncommunicable diseases interventions (WHO PEN). These package is going to help the country to improve efficiency and quality of care to control and reduce the impact of noncommunicable diseases (NCDs). The WHO PEN is an innovative and action-oriented set of cost-effective interventions that can be delivered to assure an acceptable quality of care, even in resource-limited settings.

The WHO Africa Regional Office noncommunicable diseases advisory team lead by Dr Mohamed Ould Sidi Mohamed, Medical Officer for NCD Integrated Management, made a technical assistance visit to Cabo Verde from 21 to 25th October. The team recommended the adoption of simplified protocols at primary health care units to facilitate the management of NCDs both from the health provider and community perspectives, based on the importance of getting the services in nearby facilities, which will have an impact in the standardization of NCDs management across the country.

WHO PEN protocols were adopted after a two-day workshop that counted with the participation of the relevant stakeholders of the health sector in Cabo Verde. The National Health Director of Cabo Verde, Dr. Artur Correia, highlighted that “communicable diseases are giving a way to noncommunicable diseases and becoming the major threat for the country.”

These protocols included an integrated management of hypertension and diabetes to reduce complications, such as heart attack, stroke, and end stage renal failure; management of asthma, and early detection of cervical and breast cancers. The Disease Prevention and Control Director at the Ministry of Health, Dr. Jorge Noel Barreto, stressed the importance the mission as “it help us to organize ourselves through simplification of procedures to deal with NCDs”.  

Following the protocols adoption, the Ministry of Health and WHO country office organized a three-day training of trainers (ToT) program. The main objective of the ToT was to multiply in cascade the protocols training to be used at primary health care level. Nearly 15 health technical staff attended the ToT program. It included health care providers from the pilot Primary Health Centers of Achada Santo Antonio, Tarrafal and Ponta D’Agua, and Central Hospital Agostinho Neto, in Santiago Island; and from Primary Health Center of Monte Sossego and Central Hospital Baptista de Sousa, in S. Vicente Island. 

“This WHO protocols adoption and ToT is an occasion for Cabo Verde Government to demonstrate its leadership and attention to the care of the population. It is one of the best ways to strengthen the Cabo Verde health system to manage NCDs chronic diseases and to attain Universal Health Coverage", stressed Dr Mohamed Ould Sidi Mohamed.

Dr. Idelmira Horta, medical doctor of the Achada Santo Antonio Health Centre, considered the training to be “very pertinent because it allows better management of the available resources and better channeling of these resources to what is really important. This includes human and material resources, and avoiding the discontinuation of services, while facilitating the inclusion of the community perspective within the system, making its role critical and promoting its engagement and ownership.” During the training, practical sessions were conducted to assess health facilities capacities, in three pilot primary health care centers: Achada Santo Antonio, Tarrafal and Ponta d’Agua.

According to Dr. Emília Castro Monteiro who is the WHO PEN Focal Point and Diabetes Program Coordinator at the Ministry of Health in Cabo Verde, “it is planned to start the program in a phased approach, beginning in three health centers in Santiago Island. This will allow to monitor and evaluate the progress regularly in order to scale-up the implementation progressively.” 

Dr. Flávia Semedo, WHO Cabo Verde technical officer, expressed that “the WHO Cabo Verde Country Office will continue engaged to support the Ministry of Health and Social Security in the implementation process of the WHO-PEN”.

The WHO Africa Regional Office noncommunicable diseases advisory team mission to Cabo Verde was composed by Dr Mohamed Ould Sidi Mohamed, Medical Officer for NCD Integrated Management, Dr Patrcik Kabore, Medical Officer for NCD Integrated Management, Dr Yacoub Ahmedou, Medical Officer, and Dr Fassil Shiferaw, Diseases Control and Prevention Officer.

Following Ministry of Health statistical data, noncommunicable diseases (NCDs) are a major burden in Cabo Verde causing 70% of all deaths, of which 36% are due to cardiovascular diseases and around 5% are due to diabetes. Cancer accounts for 11% of death in the country. To reduce this burden the country is committed to work on health promotion to reduce major risk factors (such as tobacco, unhealthy diet, physical inactivity, and alcohol abuse) and promote early detection, treatment and health care at primary level.