There are several socio-politico-economic realities that present challenges to CVD prevention in low-income countries such as Kenya.

The epidemiologic and socio-politico-economic realities need to be taken into account when developing contextually appropriate programs for CVD prevention.

Engaging the entire care cascade across all levels of the health system can yield high-quality, comprehensive, coordinated, and sustainable care for CVD and CVD risk factors.

Elements of engagement of the care cascade include: 1) population-wide screening for hypertension and diabetes; 2) engagement of community resources and governance structures; 3) geographic decentralization of care services; 4) task redistribution to allow for more efficient use of available human resources for health; 5) ensuring a consistent supply of essential medicines; 6) improving physical infrastructure of rural health facilities; 7) developing an integrated health record across all levels of the health system; and 8) targeted, strategic use of mHealth initiatives to provide clinical decision support and record-keeping functions for rural clinicians.