New implementation research studies for the prevention and control of noncommunicable diseases

Integrating primary care-based service delivery is a pivotal strategy to address the growing burden of noncommunicable diseases (NCDs). Integrated health services combine a range of essential health services into a coordinated and comprehensive system, with a primary care setting as the central point of access for individuals and communities. Examples of integrated services include delivering preventive, promotive and curative services for diabetes in a coordinated way across different health and social care teams or piggybacking available HIV services to test for hypertension.

This approach is particularly promising for low- and middle-income countries (LMICs), who are facing a rising burden of NCDs while still managing other pressing health priorities like HIV, TB and maternal health.

Experiences drawn from the implementation of WHO's Package of Essential Noncommunicable Disease Interventions (PEN) at the primary care level in LMICs have yielded notable improvements in NCD prevention and control. Nevertheless, sustaining progress and scaling up these interventions remains an ongoing challenge, compounded by resource constraints and capacity limitations in LMICs. Knowledge gaps persist in adapting multifaceted interventions, transcending traditional linear policy approaches, and engaging communities and populations effectively. Given the intricate nature of integration reforms, there is a need for more technical assistance on incorporating NCD services into PHC.

To bolster these endeavours, the WHO NCD Department and the Alliance for Health Policy and Systems Research (the Alliance) have joined forces to embark on a new collaborative implementation research (IR) initiative to improve the integrated management of NCDs in PHC. Specifically, our collective efforts aim to:

• Foster the generation of locally relevant evidence to inform policy and practice, thereby enhancing NCD management in PHC;
• Strengthen the capacity of countries and regions to produce this crucial evidence;
• Facilitate networking opportunities for shared learning and support; and
• Advocate for increased funding and political commitment by championing a research agenda that identifies key challenges and priorities.

With support from Norad, the Norwegian Agency for Development Cooperation, the WHO NCD Department and the Alliance issued a call for proposals for Implementation research for the prevention and control of noncommunicable diseases. This call prioritized proposals from Ethiopia, Ghana, India and Nepal, building upon existing capacity strengthening initiatives related to NCD-focused IR. The call received 194 proposals from 40 countries across WHO's six regions. Following a rigorous selection process involving initial screening, detailed review and engagement with respective WHO country offices and regional offices, the following four studies were selected:

Selected country case studies