Table 1 Core findings from site visit’s guided discussion on heart health priorities

How important is heart health to the patients seen in the clinic and community?

•Big gap in continuity of care

•Majority of patients do not prioritize heart health

•After improvement in symptoms, most patients do not return to clinic

•Awareness in the community is low

•Patients do not come to the clinic until they develop severe symptoms and complications

•Hospital administration has set special cardiac clinic day

Would you consider HF a key health condition of concern for the clinic and/or community?

•Limited cardiac services available and many patients in the community have not been reached

•Most patients managed in the clinic reported with heart failure at baseline

Are there any other core health issues of concern at the clinic or the community?

•Lack of family support worsened by stigma and poverty

•Wide catchment area means long distances to the hospital

•Chronic conditions such as hypertension, diabetes, sickle cell disease (weekly), HIV (daily clinic), kidney disease are common cause or comorbidities of heart disease

Are there any challenges or opportunities associated with clinic or community care?

•Cardiac clinic operates autonomously with little or no intrusion from the hospital top management

•Concern on continuity of the program once adapted

•Clinic needs weigh scale & blood pressure machine

•Essential medicines & laboratory reagent stockouts due to procurement gap

•Patients cannot manage financial burden that comes with heart disease

•Staff desperately need in-service training in the current medical practice for heart health

•Program could address failure to attract and retain clinical specialists affects full-time patient care delivery

•Supply of essential drugs and the availability of basic diagnostic equipment for cardiovascular diseases is a challenge

•No established drug distribution community model

•Clinicians travel to lower-level units to provide support by reviewing patients