Introduction
The CARDIO4Cities Playbook
CARDIO4Cities is an urban population health approach to address cardiovascular disease (CVD), the world’s leading cause of death and disability. The Novartis Foundation designed, co-developed and validated the approach in collaboration with the health authorities in three pioneering cities: São Paulo, Brazil; Dakar, Senegal; and Ulaanbaatar, Mongolia. This approach is currently being replicated in over twenty cities globally.
The objective of the CARDIO4Cities Playbook is to outline this evidence-based approach to improving cardiovascular population health, allowing new cities to take action. CARDIO4Cities is not a one-size-fits-all approach, but a validated process which incorporates a set of interventions that should be adjusted to local needs. The playbook provides a process to set ambitious yet realistic targets, developing a population health roadmap with concrete interventions, responsibilities and timelines, and tracking progress to adjust interventions as needed.
In addition to framing this approach, the CARDIO4Cities Playbook incorporates CARDIO4Cities in Practice which describes prior successful interventions that future cities can consider while developing their population health roadmap.
CARDIO4Cities stepwise implementation guide
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The Logical Framework of CARDIO4Cities
The Novartis Foundation has refined a Logical Framework that characterizes the translation of CARDIO4Cities interventions into immediate and long-term outcomes. This framework can be a foundational component for a city to use when developing their specific CV health strategy.
Outcomes
80% of patients2 treated and 70% controlled
90% of patients diagnosed
Policies reviewed and updated where necessary
Progress towards targets measured and reviewed
Intersectoral players engaged
Program owned by local Stakeholders
Output
Improve quality and coordination of Care3
Early Access to health and care
Reform policies with proven health benefit
Leverage Data and Digital technology
Create Intersectoral collaboration
Ensure local Ownership
Activites (Interventions – see CARDIO4Cities in Practice)
- Simplify clinical guidelines
- Continuous medical education
- Access to medicine
- Tracking in Primary care
- Treatment adherence
- Patient self-management
- Screening Corners
- Mobile Screening
- Self-Screening
- Referral Pathways
- Health literacy
- High-risk populations
- Health policy review
- Task shifting
- Continuously progress monitoring
- Health Tech Innovation
- Simulation tools
- Barrier detection
- Intersectoral Steering Committee
- Employers/private sector engagement
- Education engagement
- Stakeholder mapping
- Local governance model
- Local context analysis
- Intervention identification
[1] With local health authorities and/or health system managers
[2] CV risk factors: high BP, high LDL, diabetes
[3] Cardiovascular (disease)
The CARDIO4Cities pillars “Improve quality and coordination of Care” and “Early Access to health and care” directly address the patient journey through an improvement in knowledge, engagement, diagnosis, and follow-up management.
The other four CARDIO4Cities pillars: “Reform policies with proven health benefit”, “Leverage Data and Digital technology”, “Create Intersectoral collaboration”, and “Ensure local Ownership” address the supporting environment and infrastructure for better CV health.
