Political will and governance: keys to Implementing HEARTS in Peru

The objective of this article is to describe how governance and political will have influenced the implementation of the HEARTS Initiative for the prevention and control of hypertension in the Peruvian health system.
The governance process is described and a secondary data analysis compares baseline levels at the start of HEARTS phase 1 with observed levels after the first six months of follow-up in 34 health facilities.
HEARTS implementation was planned and organized at the national level through the Directorate of Noncommunicable Diseases, with political support from senior management of the Ministry of Health and technical support from the Pan American Health Organization. Governance was structured at three levels: national, regional, and local; implementation was supported by key actors from academia, scientific societies, regional
health directorates, and integrated networks. Results after the initial months of follow-up showed an increase in the coverage and control of hypertension in most of the participating facilities. Analysis of the key factors related to political will and governance in the implementation of the HEARTS Initiative for the prevention and control of hypertension showed that the functions of senior management—in terms of aligning public policies and prioritizing noncommunicable diseases in close and permanent coordination between policymakers and the Minister of Health—had a positive effect on the implementation of the HEARTS Initiative in Peru.