Assessment of the Global HEARTS Initiative implementation in Morocco

The Global HEARTS Initiative was launched in 2016 as an evidence-based package to strengthen the prevention and management of cardiovascular diseases in primary health care.

To assess implementation of the Global HEARTS Initiative in Morocco.

Between July 2023 and March 2024, we interviewed 131 patients, 39 health care professionals and 9 health managers, and observed service provision, at 4 pilot health centres in the Tangier-Tetouan-Al Hoceïma Region of Morocco, on the implementation of the Global HEARTS Initiative. We analysed the data using Jamovi 2023.

Most health care professionals (57.1%) interviewed were recommending one counselling session per quarter to patients, with majority (60.6%) preferring sessions lasting < 15 minutes. Majority of the patients (96.9%) interviewed reported receiving advice on healthy lifestyle practices. Availability of essential medicines and technologies varied across the centres. However, most of the health care professionals (76.3%) reported availability at their centres and most of the patients (98.5%) reported being counselled on the appropriate use of cardiovascular medicines. Patient registration in the HEARTS information system was low (3.9-12.1%) across centres. There were difficulties in obtaining essential medicines, only 25.6% of the health care professionals had received training on HEARTS, there were technical problems with the HEARTS information system, and persistent gaps in coordination and communication within and across different levels of the health system.

Certain systemic barriers hinder effective implementation of the Global HEARTS Initiative in Morocco. Addressing these barriers is critical to strengthening implementation, enhancing scale-up and sustainability, and achieving the objectives of the initiative.