Our Approach
A Ghana where every driver and trader with high blood pressure stays in care.
We educate, screen, and stay until care continues.
- Nothing About Us Without Us.
- Closed-loop accountability.
- Faith-rooted, community-trusted.
- Diaspora and homeland in partnership.
- Aligned with the system.
The Transport Hub Ecosystem
The Initiative 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.
The Initiative focuses on trotro drivers and market women in Greater Accra for a specific reason.
They are the economic backbone of urban Ghana. Trotro drivers sit ten to twelve hours a day in traffic, under chronic stress, often consuming salt-heavy street food, often without health coverage. Market women stand for hours in the heat, relying on processed foods high in sodium. Both groups face elevated cardiovascular risk and are excluded from a clinical system that only serves people who walk through its doors. When a driver or market woman has a stroke, an entire family loses its primary income. This is a health crisis and an economic one.
Three Pillars of Community Health
Every element of the Initiative's model is designed to work as an integrated system, not isolated activities.
Education
Knowledge Is Protection
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Before screening, the Initiative will deliver accessible health education through trained peer educators using a two-track curriculum: Training of Trainers (ToT) and Community Volunteer Training. The curriculum draws on a curriculum for religious leaders developed in Mwanza, Tanzania (Cohen 2025), from the NIH-funded work of Dr. Jennifer Downs and colleagues at Weill Cornell Medicine and partner institutions in Mwanza. It also integrates Dr. Monika Safford's Patient Activated Learning System (PALS), delivered through MedExplain Health.
- 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
Screening
Simple, Accessible, Life-Saving
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Community-based blood pressure measurement using WHO-protocol methods, available where people already gather, at lorry stations and markets.
- Brief registration and health history intake
- Rest period for accurate readings
- WHO-protocol blood pressure measurement
- Personalized risk counseling
- Resource packet for every participant
Referral & Follow-up
The Closed Loop
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Screening events are necessary. Sustained follow-through is harder. The Initiative is designed to do the longitudinal work, tracking participants for 12 months at Days 14, 30, 90, 180, and 365. Referrals route through Ghana's existing care infrastructure: NHIS-enrolled clinics, FPHC primary care, partnered pharmacies, and faith-based facilities in the networks of the Christian Health Association of Ghana (CHAG, a recognized agency of the Ministry of Health, working in all 16 regions) and the Catholic Health Service Trust.
- Referral to practitioner network
- Track who connects to care and stays in care
- Measure blood pressure outcomes over time
Supporting Ghana's Free Primary Healthcare Programme
On April 15, 2026, President Mahama launched the Free Primary Healthcare Programme (FPHC). He said every Ghanaian should be screened at least once a year, hypertension included, and that community health nurses and volunteers would play a critical role. As of September 2026 the programme is live in 135 districts across all 16 regions, in more than 4,400 facilities. Its first phase covers 150 districts, and national implementation is targeted for 2028.
The Closed-Loop Framework: 12-Month Patient Tracking
The Initiative 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.
Along the way, the Initiative connects participants to licensed clinics and pharmacies and supports NHIS enrollment; the Initiative does not dispense medication.
"The closed loop is the intervention."