Implementation of the Package of Essential Non-Communicable (PEN) Disease Interventions in Low-Resource Settings: A...

To deal with the rising prevalence and death rate of non-communicable diseases, the WHO designed a package of essential interventions for non-communicable diseases for low- and middle-income countries. This review aimed to identify the barriers and facilitators of the implementation of this program.

The electronic databases of PubMed, Scopus, Web of Science, Cochrane Library, and Scientific Information Database (SID) were searched for papers without a time limit at the end of Dec 2020. Only English and Persian languages were considered. The PRISMA guideline was consulted.

Overall, 15 articles were selected for the final analysis out of 404 initially retrieved ones, based on inclusion/exclusion criteria and quality assessment. Thirteen articles had good quality, while 2 articles were of fair quality. Studies were published during 2014-2020. Thematic analysis was used to make sense of papers so that barriers and facilitators were categorized within 2 main themes and 7 sub-themes. Certain organizational factors including human resources, service delivery, structure, leadership/governance, data and information, resources, and financing were identified as barriers and facilitators. Knowledge and culture, and economic and social factors were identified as contextual factors.

By considering the factors identified in this study, policymakers and health system managers can be more successful in implementing this WHO PEN and similar packages.