Decentralization and Integration of Advanced Cardiac Care for the World's Poorest Billion Through the PEN-Plus...

Area of Science:

• Cardiology
• Public Health
• Global Health

Background:

• Heart diseases are leading causes of death in low- and lower middle-income countries (LLMICs).
• Access to advanced cardiac care is limited for the rural poor due to shortages in diagnostics, medications, and healthcare workers.
• Current advanced cardiac care is concentrated in urban tertiary centers.

Purpose of the Study:

• To describe how the Package of Essential NCD Interventions - Plus (PEN-Plus) model addresses the need for advanced cardiac care in high-poverty settings.
• To discuss the promotion of a shared operational strategy for managing severe cardiac disease in resource-limited areas.

Main Methods:

• The study describes the PEN-Plus integrated care model for severe chronic noncommunicable diseases (NCDs).
• It highlights the decentralization of services and increased access strategies within PEN-Plus.
• It discusses the collaborative efforts of global cardiac organizations through the PEN-Plus Cardiac expert group.

Main Results:

• PEN-Plus is being adopted by an increasing number of LLMICs.
• The model aims to decentralize essential NCD services, including advanced cardiac care.
• Global cardiac organizations are collaborating to develop a unified operational strategy.

Conclusions:

• The PEN-Plus model offers a viable strategy to improve advanced cardiac care access in underserved populations.
• Integrated care models are crucial for managing severe NCDs in resource-limited settings.
• International collaboration is key to implementing effective cardiac care strategies in high-poverty regions.