Addressing the Silent Killer: A Collaboration for Proactive Hypertension Management in Kenya
Hypertension, often referred to as the "silent killer," is one of the leading non-communicable diseases (NCDs) worldwide, especially in low- and middle-income countries. In Kenya, where healthcare access can be limited, this condition remains largely underdiagnosed and inadequately managed. Without timely intervention, hypertension can lead to severe cardiovascular complications, affecting both individuals and the broader healthcare system.
To address this growing crisis, the Grants Team from Endless Foundation has partnered with Penda Health, a private clinic network in Nairobi, to implement the BP Sawa Project, a technology-driven, patient-centered hypertension management initiative. As a research and resource partner, Endless Foundation also brought in Ariadne Labs, a renowned research center affiliated with Harvard University, to help design, implement and document the BP Sawa program.
The Problem
Penda Health, recognized that many patients were potentially hypertensive but often missed early detection and consistent management due to the clinic's passive, reactive approach to care. With limited resources and reliance on traditional clinical models, there was an urgent need for a solution that could make hypertension care both accessible and sustainable.
Key Goals and Learnings
The goal was to create a system where technology and personalized, proactive care could work together to improve hypertension management in a low-cost, scalable way. At the outset, we set several ambitious goals for this collaboration:
Design a Patient Journey for Hypertension Care:
Our first goal was to design a hypertension-specific patient journey supported by an AI-powered WhatsApp chatbot that would help manage patient interactions, provide proactive reminders, and offer continuous guidance. However, as we delved into the problem more by studying existing patient journeys and provider feedback, we realized that the initial solution required more than just technology. We needed to focus on more fundamental elements like provider training, patient education, trust-building, and the creation of effective clinical protocols. The development of clinical practice guidelines and a BP Passport (a simple tabular log-book for patients to easily keep track of their BP levels over time) was crucial in achieving these objectives.
Test the Effectiveness of Intangible Incentives:
We also aimed to explore the impact of incentives like a loyalty rewards program to encourage regular blood pressure screenings and medication adherence. While this proved difficult in the short six-month pilot, we learned valuable lessons about the importance of building patient trust. Many patients were initially skeptical about the need for hypertension care, especially since it’s often asymptomatic. By providing affordable medications and free screenings, we began to see improved adherence.
Enable Better Self-Care and Management:
By the end of the pilot, nearly 3,700 patients had been identified with untreated hypertension or pre-hypertension, and over 20% of them were brought into routine care. This is a remarkable achievement when compared to the baseline of just 3%. However, it’s clear that more work needs to be done to educate patients about the importance of managing asymptomatic NCDs.
Prove Cost-Effective Patient Engagement:
We tested whether technology could enable cost-effective patient engagement and standardization of care while fitting into the business model of a private clinic. While technology wasn’t the sole solution, we demonstrated that integrating proactive NCD management into a clinic’s business model can increase patient loyalty and retention, driving both health outcomes and clinic revenue. Penda Health is now committed to scaling this program across all 16 of its clinics.
Collaboration Between Private and Academic Partners:
Finally, we sought to determine whether a partnership between a private health provider and an academic institution could complement each other's expertise. The success of this collaboration, with Ariadne’s support in developing patient journeys and Penda’s capacity to implement and scale, offers valuable insights for future partnerships in global health.
Rubayat's Perspective: The Future of Primary Care
As the Health Programs Director at Endless Foundation, I have a front-row seat to witness the power of innovation by the world’s best entrepreneurs and the impact it can have when thoughtfully applied to global health challenges. The BP Sawa project is a prime example of how problem-driven, people-centered innovation can lead to transformative impact, even in settings with limited resources.
The biggest takeaway from our partnership with Penda and Ariadne Labs is that solving complex health issues like hypertension requires more than just technological solutions. It demands a deep understanding of current patient journeys and their challenges, provider orientation and incentives, and the cultural contexts in which these interventions take place. The success of this project highlights the importance of building trust and empathy between patients and providers—two elements that cannot be replaced by AI or digital tools.
Looking forward, our partnership with Penda Health is just the beginning. We are excited to see this model scale to all 16 of Penda’s clinics, which could potentially reach over 300,000 patients. But the work doesn’t stop there. We are in discussions with Kenya’s Ministry of Health to bring these innovations to the public sector, working together to bridge the gap between private-sector solutions and public-sector health needs.
In the future, we envision a world where primary care is more proactive than reactive, where digital and AI tools help us manage chronic diseases before they become life-threatening. The lessons learned from BP Sawa will serve as a foundation for all our future projects and collaborations.
What Can You Do?
Educate yourself about the dangers of unmanaged hypertension and diabetes, particularly in their asymptomatic stages.
Health providers and implementers: Study existing patient journeys to identify barriers and improve care before launching interventions.
Funders and multilaterals: Support more projects aimed at managing NCDs, as the burden on health systems is already overwhelming.
Global health leaders: Advocate for the shift from passive, transactional healthcare systems to proactive, patient-centered models that are ready for the future.
At Endless Foundation, we’re not just dreaming of a healthier world; we’re creating it, one partnership at a time.