Integration of NCD screening, management and care continuity through primary health care using pen program in Nepal: assessing practices and barriers

Abstract

Conclusion: The study reveals several gaps in PEN service provision in all levels of health systems including inadequate budget, human resources, medicines, equipment, NCD recording and reporting forms, supervision and monitoring, and financing. PEN guidelines use is also limited by service providers at the primary healthcare facilities. Findings from the study, including the factors affecting the success or failure of the program, will be used for improving the performance as well as to plan the further scale-up of the PEN program in Nepal. Government should strengthen PEN implementation through training all staff in PHCs and HP through onsite or online platform; train a cadre of health providers to share tasks and delivery NCD care (such as counselling, monitoring of BP, glucose, medicine, community awareness) at the community level; ensure adequate finances and set up of diagnostic tests, supplies, equipment and medicine; expand social health insurance to all health facilities; make protocols visible and easier to use; integrated NCD information into HMIS and DHIS-2; systematically supervise and monitor PEN program; and extend communitybased activities to raise awareness and strengthen linkages with clients.