A multi-sectoral, non-governmental program for control of rheumatic heart disease: SUR I CAAN: A model for developing countries.

Rheumatic heart disease (RHD) is a leading cause of cardiovascular mortality in developing countries. Control of RHD requires addressing the disease at its different stages through health system variables that are complex and intersecting. To achieve that, a multi-sectoral program is needed that is best implemented through ministries of health. In this report we present the SUR I CAAN program (Surveillance, Integration, Communication, Awareness, Advocacy and Training) that is implemented in Sudan utilizing nongovernmental resources and nonconventional funding. The program objectives are: 1. To improve primary, secondary and tertiary prevention of RHD, 2. To improve public awareness, 3. To implement strategic research projects, and 4. To improve advocacy through collaboration with regional and international organizations dealing with RHD. We established a hospital-based register and managed to identify high burden areas where sentinel sites for RHD control were established. A package of training and awareness material was utilized to conduct training workshops in these areas. Handheld echocardiography was utilized for studying the prevalence as well as for early detection and treatment of RHD. Although we did not conduct a structured evaluation for this program, we believe that its structure can serve as a model for other resource-limited countries.