Technical support in strengthening NCD care cascade in Kavrepalanchowk district

Project Summary

The non communicable diseases (NCDs) are the major leading cause of deaths in Nepal. The burden of disease has increased over the years which requires immediate action for its prevention and control. The management of NCDs needs to be more robust with referral and counter referral service, a linkage to continuum of care delivery from community and back to the community level. The case detection, management and control of hypertension is also a challenge in Nepal. There is a huge gap in clinical monitoring, patient tracking through referral and counter referral mechanism, evaluation and follow-up with a continuum of care approach. These challenges can be addressed by institutionalizing NCD care cascade across primary healthcare centers ensuring its accessibility to all health facilities in the district.
In this project, therefore, our aim is to strengthen NCDs care cascade in Kavrepalanchok district through collaborative effort between academia, Health Office, Provincial Health Directorate, Epidemiological and Disease Control Division, Ministry of Health and Population, Government of Nepal and World Health Organization. We aim to reach all the 90 health facilities in the district as per need of the district to strengthen NCD care cascade specifically for hypertension and diabetes. We will monitor coverage and cohort outcomes to develop differentiated care for those with high risk of adverse health outcome and falling off the care cascade. This project will also document bottlenecks, barriers and facilitators at each step of the service continuum and identify practical solutions to maintain care cascade to improve coverage, quality and efficiency services.

Study Duration

From September 1st, 2023


1. To monitor and evaluate facility and patient level indicators in regards to hypertension and Diabetes in health facilities of Kavrepalanchok district.

2. To develop a robust referral and counter referral mechanism between DHKUH/KUSMS and health facilities of Kavrepalanchowk districts, ensuring a strong continuum of care for patients with hypertension and diabetes including timely screening, diagnosis, monitoring, treatment adherence and advocating NCD risk factors to health facilities management committees and promoting community participation.

3. To explore facilitators and barriers for implementing NCD care cascade among health care professionals in Kavrepalanchowk district at each step of the service continuum.

4. To develop & implement practical solutions to maintain NCD care cascade (hypertension & diabetes) for coverage, quality and efficiency of services.

Team Members

Principal Investigator(s): Dr. Abha Shrestha

Co-Investigator(s): Dr. Biraj Man Karmacharya, Prof. Dr. Jagdish Chataut, Dr. Archana Shrestha, Dr. Puspanjali Adhikari, Dr. Rajani Shakya, Dr. Pranil M Singh Pradhan, Dr. Prajjwal Pyakurel, Ms. Rabina Shrestha, Ms. Deepa Laxmi Makaju, Ms. Prajita Mali

Project Coordinator: Ms. Ashraya Acharya

Research Assistants: Ms. Jenisha Shrestha, Ms. Rashmi Shrestha, Ms. Anusha Basnet, Ms. Manisha Makaju, Ms. Smriti Chudal, Ms. Sona Gautam

Collaborating Partners: Health Office, Kavrepalanchok District, Nepalese Society of Community Medicine (NESCOM)

Supporting Partners: WHO Country Office, Nepal