Management of hypertension utilizing trained community health worker in rural municipalities of Nepal (MUTU)


Research objective: To evaluate whether existing Facility-Based Community Health Workers (FB-CHWs) and Female Community Health Volunteers (FCHVs) of Ministry of Health can collaboratively diagnose hypertension and initiate/maintain protocol-based hypertension treatment with amlodipine and contribute to a reduction of blood pressure among untreated hypertensive patients at baseline.

Research method: Quantitative

Study design: It is a quasi-experimental pre-post study design.
The research method is quantitative with the primary outcome is the net change in systolic blood pressure. The secondary outcome is a change in diastolic blood pressure, the proportion of hypertension control (systolic <140 and diastolic <90 mmHg).

Study site: Rupa Rural Municipality of Kaski District, located in the Gandaki Province of Nepal and Biruwa Rural Municipality of Syangja District in the Gandaki Province.

Study Population: All the adults aged 25-70 years of age and who are permanent residents of the Rupa and Biruwa municipalities.

Procedures: Facility based-community health workers (Fb-CHWs) and Female community health volunteers (FCHVs) both go through extensive training regarding the burden of hypertension; risk factors of hypertension; blood pressure measurement by a digital BP device, referral procedures; personalized health promotion counselling on lifestyle changes; and recording, reporting, and follow-up procedures. FB-CHWs receive training on initiating the treatment of hypertension using amlodipine based on the study protocol.

Ethical consideration: Ethical approval is obtained from Nepal Health Research Council. Written consent will be received from the participants prior to data collection. 

Data safety and monitoring board: Is formed and regularly updated.


Validity and Reliability of the Study Tools: The WHO STEP Survey tool is taken as a      reference material for baseline and follow-up survey which was validated and previously used by Nepal Health Research Council. 

Expected outcome: This study is the first of its kind to evaluate the possibility of utilizing the trained community health workers to reduce the burden of hypertension in LMIC. If our study shows that the intervention is effective, a scaled-up approach could produce an important reduction in cardiovascular disease burden due to hypertension in Nepal.


Project Members

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Success Stories

What people learned from us
  • I am Gaun Sabha Sadasya of Rupa Gaupalika Ward no. 6, Captain Harka Bahadur Gurung. Data enumerators of MUTU program visited various clusters to measure blood pressure. Those with high blood pressure were requested to visit the health post and have gotten better with the treatment. Some people have quit taking alcohol, that we have observed. Among them, one is a person from my Ward no. 6 who resides nearby our Ward office. He used to drink alcohol regularly but he cannot speak as he is differently able. Yesterday when I checked on him and asked “did you drink alcohol?”, he nodded saying “no, I have not drunk alcohol”, I asked him “why did you not drink alcohol?”, he gestured “I have high blood pressure, so”… then I was happy…If we could continue the program, our Rupa Gaupalika and our country would really benefit and become better. In this regard, I would like to thank MUTU staff, health post staff, in-charge, doctor and all, above all I would like to thank the young leader of Rupa Gaupalika, Mr. Nabraj Ojha because through him MUTU program got initiated here, I will stop my words here.

    Thank you very much. Here is our Ananda Joshi sir, Rupa Hospital staff and MUTU staff.

    Captain Harka Bahadur Gurung
    Gaun Sabha Sadasya, Ward no. 6