In Rwanda, patients with heart failure may have low health education about their condition. Heart failure care requires active patient involvement. Self-care of heart failure requires healthy lifestyle, attention to symptoms, proper action when new symptoms develop. However, many patients may choose to stop taking medications when they are feeling well, or disregard new symptoms when they develop and delaying care until their condition is more severe. Educating patients in self-care for heart failure can be achieved by clinical staff with the support of patient handbooks or flip books. Self-care education materials have been developed by the research team in Haiti and have been adapted for Rwanda.

This study will use a cluster, stepped wedge design. Patients are already in clusters based on their health facility. The order of implementation will be randomized by the cluster. The primary outcome is heart failure knowledge assessed pre- and post-intervention through a structured survey.