Models of care for noncommunicable diseases in primary care

Key elements and design in low- and middle-income countries – a scoping review

Datos Bibliográficos

ID19530708
AutoresMai Eltigany (World Health Organization, autor de correspondencia), Laura Drown (0000-0002-5322-6834, Brigham and Women's Hospital), Oyetayo Akala (World Health Organization), Silvia Ussai (0000-0002-8044-7173, World Health Organization), Gene Bukhman (0000-0003-4500-7903, Brigham and Women's Hospital), Alarcos Cieza (0000-0002-5045-4890, World Health Organization), Alma J Adler (0000-0002-6700-3279, Brigham and Women's Hospital)
Año2025
Volumen18
Número1
Páginas2543604-2543604
Fecha de publicación2025-12-31
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaGlobal Health Action (JOURNAL)
Identificadores de la revistaISSN: 1654-9716 • E-ISSN: 1654-9880
EditorialInforma UK Limited (PUBLISHER • GB)
DOI10.1080/16549716.2025.2543604
PMID40875014
OpenAlexW4413779528
IdiomaEN
Citas recibidas1
Referencias citadas57

Noncommunicable diseases (NCDs) pose a global health challenge, with primary health care's (PHC) potential to address them underutilized. While efforts to design and implement effective NCDs care models in low- and middle-income countries (LMICs) are increasing, conclusive recommendations are lacking. This scoping review maps literature on NCDs care models in LMICs, examining elements, theoretical foundations, and outcomes to inform the development of context-specific models. Following Arksey and O'Malley's framework, we searched PubMed, Embase, and Web of Science for articles on NCD care models in LMIC primary care. Two authors independently screened and extracted data using a 40-element framework. Identified models were categorized as implemented or theoretically proposed, analyzed by subcategory, and elements identified and compared. The search and snowballing yielded 1,011 articles. 54 met inclusion criteria, covering 44 models (25 implemented, 19 proposed). Implemented models' design was largely informed by service delivery gaps analyses. The most frequently included elements in them were education and training of the health workforce, combined self-management and patient education, guidelines/protocol-based approach, information systems, screening, team-based care, combined nurse-led and task shifting/sharing, essential medicines, essential diagnostics, community-level care, standardized referral pathways, and mentoring and supervision. Comparison of frequently included elements in implemented and proposed models showed strong alignment between them and with the recommended interventions in WHO-NCDs technical packages for primary care. This underscores these elements' relevance in addressing NCD service delivery challenges in LMICs and guiding the reorientation of PHC models to better integrate NCD services. However, further evidence is needed to support implementation

Developing country · Development economics · Economic growth · Economics · Environmental health · Family medicine · Global health · Health care · Low and middle income countries · Primary care · Primary health care · Chronic Disease Management Strategies · Computer Science · Global Public Health Policies and Epidemiology · Healthcare Systems and Reforms · Medicine · Gerontology