The CARDIO4Cities approach

6 pillars for rapid and sustainable impact

CARDIO4Cities helps cities move from health insight to coordinated action. The approach combines data, local priorities, evidence-based interventions and cross-sector collaboration to help city leaders and health authorities reduce cardiovascular risk at population level.

The model is designed to be structured enough to guide implementation, but flexible enough to be adapted to each city’s health system, communities and needs.

C

Improve quality and coordination of Care

Streamline cardiovascular risk factor management and train the health workforce on consistent use of guidelines, algorithms and clinical decision support tools. Introduce task shifting for improved performance, access and quality of care. Engage patients in self-management to ensure adherence and follow-up to achieve risk factor control.

A

Early Access to health and care

Accelerate early detection, bring cardiovascular health closer to where people live, work and play by optimizing cardiovascular risk factor measurements throughout the city, within and outside health facilities, ensure strict/automated referral for diagnosis confirmation, treatment and follow-up, and ensure medication availability for all.

R

Reform policies with proven health benefit

Implement policies to support health system reforms and those with proven population health benefits, including lifestyle policies that encourage healthier living and policies that make health services more accessible for all.

D

Leverage Data and Digital technology

Set ambitious targets for people with CV risk factors diagnosed, treated and controlled and define a set of minimal essential data to track progress and outcomes. Facilitate periodic data reviews by the governance boards, with simple dashboards. Leverage technology to support patients and health workers, and to overcome bottlenecks in health service delivery.

i

Create Intersectoral collaboration

Partner with schools, workplaces (large and small employers), community organizations, food associations, transport and housing authorities, and others to promote healthy lifestyle (“health in all policies”) and early detection of CV risk. Engage payers and/or ministries of finance to optimize budgets for population health.

o

Ensure local Ownership

City and health authorities, health system managers, local communities, patient associations and civil society organizations must co-own the initiative at every stage, including design, implementation, progress, and outcome monitoring.

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.

IMPACT: A city where intersectoral partners work together1 to reduce strokes by 30% and heart attacks by 15%

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.

Ready to understand how CARDIO4Cities could work in your context?

Start with the implementation journey, then explore the pillars and intervention examples that can help cities turn cardiovascular population health plans into action.

View the Playbook