Congenital Heart Disease: The enigma of non-communicable diseases
“Congenital” represents the structural defects that are present from birth. Congenital Heart Disease (CHD) is an umbrella term used to denote structural and functional defects of the heart and the great vessels entering and/or exiting the heart.The causes are in entirety genetic, involving a myriad of interacting unpredictable complex processes. The role of the environment in its pathogenesis has become apparent through varying entangled mechanisms termed under the “epigenetics” collective.
Commonly the diagnoses are made after birth. It is however critical that the diagnoses are made during pregnancy so that condition-tailored care packages can be prescribed on individual merits. This is not always feasible. It is nevertheless advisable that all expectant mothers are booked for routine antenatal checks so that at-risk pregnancies can be identified and referred accordingly.
High-risk factors include mothers with; a previous baby diagnosed with CHD, diabetes mellitus, medications known to cause heart disease in a developing foetus, multiple pregnancies e.g. twin pregnancies, and pregnancies conceived through in[1]vitro fertilization (IVF) etc.
There is an extraordinarily high incidence and prevalence of congenital heart disease among children and adults in Namibia. The lesions range from simple to very complex. In that severe end of the continuum, are lesions that are incompatible with survival and/or life. Equally, some cannot be definitively corrected and are prescribed palliation strategies, with many life-long complications, eventually resulting in premature death.
Management for this entity of medicine is highly specialised. Sadly, trained critical human capital required to look after this population is not available en masse in Namibia.
Equally important are the material and infrastructural resources to guarantee access and distribution.
National call
Advocacy is a national call, involving multiple stakeholders from central government (the principal policymaker), corporates/ non-governmental institutions, individuals and communities. Advocacy is multi-pronged and would involve strategies such as awareness dissemination, research and training as well as strategic partnerships for resources liberation.
The Namibia National Children's Hearts Trust, which was established in alignment with, and to support the Ministry of Health and Social Services in delivering accessible, affordable, effective, efficient, equitable, patient-centred, quality, safe and sustainable care irrespective of socio-economic conditions. This agenda fully affiliates with the global agenda towards universal health coverage (UHC).
The trust can only leverage its position with collective support from multiple stakeholders' engagement.
*Dr Fenny Shidhika’s qualifications: MBChB (UCT), FC Paed (SA), Cert Cardio (SA) Paed, MPhil. Paediatric Cardiology (UCT), MSc. in Health Economics, Outcomes and Management in Cardiovascular Sciences, London School of Economics and Political Sciences (LSE).
** Opinion pieces and letters by the public do not necessarily reflect the opinion of the editorial team. The editors reserve the right to abridge original texts. All newspapers of Namibia Media Holdings adhere to the Code of Ethics for Namibian Media, a code established jointly with the Media Ombudsman.