Better Care for NCDs Initiative

Strengthening integration of NCDs into Primary Health Care represents a key milestone in a country’s health system response to the Sustainable Development Agenda, with the aim of leaving no-one behind

Purpose:

Expand equitable access of integrated and comprehensive Noncommunicable Diseases services within Primary Health Care in the Americas

Objectives:

What are the recommended NCDs services in primary care settings?

NCD services in primary care include a range of essential services from health promotion to prevention, screening, treatment, rehabilitation, and palliative care. The WHO package of essential noncommunicable diseases intervention (WHO PEN), which includes the HEARTS package for hypertension control, provides a framework for a minimum set of interventions to address the main NCDs in primary care. This PAHO initiative will build on and expand country´s current efforts to integrate NCDs into PHC, including HEARTS.

The interventions are for the detection, diagnosis, treatment, and care of cardiovascular diseases, diabetes, asthma and other chronic respiratory diseases, and cancer, healthy lifestyle counseling, self-care, and palliative care. They will be scaled up at the primary health care level. As most persons known to have an NCD frequently have more than one chronic condition, it is required a multidisciplinary approach to their diagnosis and management.

Comprehensive NCD service interventions

Cardiovascular diseases

CVD risk assessment based on the WHO CVD risk chart during clinical encounters; hypertension screening and diagnosis through blood pressure measurement; lifestyle change and drug therapy for hypertension control delivered in primary health care.

Diabetes

Early diabetes diagnosis; pharmacological treatment and clinical follow up to achieve blood glucose control; prevention of complications through retinopathy screening, diabetic foot evaluation, cardiovascular screening, delivered in primary health care.

Cancer screening

Cervical cancer screening with HPV testing; ablative treatment of precancerous cervical lesions in primary health care; breast cancer screening through physical exam and referral for mammography if indicated.

Health promotion, counselling and education for healthy living

Nutrition and healthy diet counseling, physical activity promotion, weight management, tobacco cessation, alcohol brief interventions, self-management disease or condition support, healthy schools, workplaces and community settings and linkages from community to health services.