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How GHSI Is Designed to Work

GHSI has conducted extensive research focusing on program evaluations of existing cardiovascular-focused initiatives in Ghana and Sub-Saharan Africa. We have studied what works, identified critical gaps, and designed our model to bridge them — leveraging partnerships to build capacity within existing programs rather than duplicating efforts.

TROTRO LORRY STATION • ACCRA

The Transport Hub Ecosystem

GHSI does not target two separate populations. We serve one integrated economic community: the transport hub ecosystem. Trotro drivers and market women work in the same physical space, share the same risk factors, and face the same barriers to preventive care.

By screening where they already gather — at lorry stations and major markets — GHSI reaches an entire economic community in a single intervention point. This is how we maximize impact per screening event.

Three Pillars of Community Health

Every element of GHSI's model is designed to work as an integrated system — not isolated activities.

1

Education

Knowledge Is Protection

Before screening, GHSI will deliver accessible health education through trained peer educators using a two-track curriculum — Training of Trainers (ToT) and Community Volunteer Training.

  • What hypertension is and why it matters
  • Warning signs to watch for
  • Connection between hypertension and stroke
  • Understanding symptoms as medical, not spiritual
  • The BE-FAST method for stroke recognition
2

Screening

Simple, Accessible, Life-Saving

GHSI's screening process will follow an 8-station workflow designed for community field settings, using WHO-protocol blood pressure measurement.

  • Brief registration and health history intake
  • Rest period for accurate readings
  • WHO-protocol blood pressure measurement
  • Five-tier color classification for clear results
  • Personalized risk counseling
  • Resource packet for every participant
3

Referral & Follow-up

The Closed Loop That Others Leave Open

Screening events are common. Follow-through is rare. GHSI is designed to build the bridge that others leave unbuilt — tracking participants for 12 months.

  • Referral to practitioner network
  • Follow-up at 14, 30, 90, 180, and 365 days
  • Track who connects to care and stays in care
  • Measure blood pressure outcomes over time
  • The closed loop is the intervention

The Closed-Loop Framework: 12-Month Patient Tracking

One-time screening finds hypertension. GHSI is designed to track what happens next — measuring not just who was screened, but who made it to a provider, who stayed in care, and whose blood pressure improved.

14
days
Initial follow-up completed?
30
days
Confirmed in care?
90
days
Retained in care?
180
days
BP status tracked?
365
days
BP controlled?

"The closed loop is the intervention."

Five-Tier Blood Pressure Classification

GHSI uses a five-tier color classification system aligned with ACC/AHA clinical guidelines. Each tier determines the participant's pathway — from education-only to emergency referral — ensuring every individual receives the appropriate level of response.

120/80
Green
<120 / <80
Normal — Education only
Yellow
120-129 / <80
Elevated — Enrolled in follow-up
Orange
130-139 / 80-89
Stage 1 — Clinic referral + follow-up
Red
140-179 / 90-119
Stage 2 — Urgent referral + follow-up
Dark Red
≥180 / ≥120
Crisis — Emergency care

Powered by the Simple App

GHSI has adopted the Simple app, an open-source platform developed by Resolve to Save Lives, to manage patient data and coordinate follow-up across the full 12-month cycle.

Offline-First Design

Simple works in low-connectivity environments — essential for screening at busy lorry stations and open-air markets in Greater Accra.

Proven at Scale

Simple has supported the management of over six million patients across India, Bangladesh, Ethiopia, Sri Lanka, and Myanmar.

Automated Follow-Up

Overdue patient lists and automated reminders enable GHSI's closed-loop tracking model at the 14, 30, 90, 180, and 365-day milestones.