Organization of primary health care for diabetes and hypertension in high, low and middle income countries

Expert Rev Cardiovasc Ther. 2014 Aug;12(8):987-95. doi: 10.1586/14779072.2014.928591. Epub 2014 Jun 17.


Chronic non-communicable diseases, predominantly diabetes and cardiovascular disease are a major public health problem globally. The chronicity of these diseases necessitates a restructuring of healthcare to address the multidisciplinary, sustained care including psychosocial support and development of self-management skills. Primary healthcare with elements of the chronic-care model provides the best opportunity for engagement with the health system. In this review, the authors discuss aspects of primary healthcare for management of diabetes and hypertension and innovations such as mobile-phone messaging, web-based registries, computer-based decision support systems and multifaceted health professionals in the care team among others that are being tested to improve the quality of care for these diseases in high, middle and low-income countries. The goal of quality care for diabetes and hypertension demands innovation within the realities of health systems both in high as well as low and middle-income countries.

Keywords: chronic disease care; diabetes; high income countries; hypertension; low and middle income countries; primary health care.

Publication types

  • Review

MeSH terms

  • Chronic Disease
  • Delivery of Health Care / organization & administration
  • Delivery of Health Care / standards
  • Developed Countries
  • Developing Countries
  • Diabetes Mellitus / therapy*
  • Humans
  • Hypertension / therapy*
  • Interdisciplinary Communication
  • Patient Care Team / organization & administration
  • Patient Care Team / standards
  • Primary Health Care / organization & administration*
  • Primary Health Care / standards
  • Quality of Health Care
  • Self Care