Table 7.

Key cost elements of standardised programme implementation: WHO Global Hearts Initiative, HEARTS technical package for CVD prevention in primary care.

HEARTS element	Description	Cost elements
H: Healthy lifestyles	Counselling on lifestyle changes, including tobacco cessation, dietary modification, avoiding harmful use of alcohol and increasing physical activity	Training of healthcare providers
		Provider time for patient screening and counselling
		Health promotion materials
E: Evidence-based treatment protocols	Adopting simple, standard treatment protocols for use in primary care for the management of CVD, including secondary prevention and management of high blood pressure and diabetes	Provider time for patient screening
		Provider time for physical exam
		Provider time for laboratory tests
A: Access to essential medicines and technologies	Continuous availability of essential medicines and basic technology in primary healthcare	Inventory of core medicines
		Inventory of diagnostic supplies (eg, blood pressure measurement devices, laboratory supplies)
R: Risk-based Management	Incorporating CVD risk assessment for treatment and referral	Training of healthcare providers in risk assessment
		Provider time for establishing patient risk profile using risk charts
T: Team care and task sharing	Incorporating team-based care and non-physician healthcare providers in primary care	Training of healthcare providers
		Training of supervisors
		Change in provider time across types of healthcare providers (physicians, nurses, community health workers)
S: Systems for monitoring	Establishing patient records for follow-up, tracking and reporting health outcomes	Technology (software, hardware)
		Supplies (if using paper materials)
		Administrative staff
		Training of administrative staff

CVD, cardiovascular disease.