Implementation of the Noncommunicable Disease Capacity Assessment and Planning Process in Iraq, Jordan, and Pakistan

Addressing noncommunicable diseases (NCDs) necessitates coordinated, country-tailored responses. The NCD Capacity Assessment and Planning (N-CAP) Process is a tool that strengthens public health functions and promotes multisectoral collaboration to achieve more sustainable and impactful progress. This case study describes the piloting and implementation of the N-CAP Process in the Eastern Mediterranean Region.

The N-CAP Process includes three sequential, facilitator-led activities: stakeholder mapping, a Strengths, Weaknesses, Opportunities, and Threats Workshop (SWOT), and an N-CAP Workshop. Jordan, Iraq, and Pakistan were identified as countries with ministries of health with sufficient resources to implement the N-CAP Process and its recommendations. The N-CAP Process was piloted in Jordan (2021), revised for Iraq (2022), and implemented in its final version in Pakistan (2023). Qualified local facilitators and recorders were trained in each country prior to use. Stakeholder mapping was conducted in coordination with the ministries of health to identify multisectoral, technical, and policy stakeholders to participate in the activities. The SWOT Workshops convened stakeholders to assess the current landscape and identify critical NCD public health functions. The N-CAP Workshops used discussion guides to facilitate assessment and planning exercises that helped participants determine how to strengthen capacity within the critical NCD area.

The N-CAP Process led stakeholders to assess their country's efforts across six public health domains (strategic direction, systems, resources, quality, engagement, and impact) and create prioritized recommendations or a plan to reach a higher level of functioning to better address NCDs. Participants in Jordan, Iraq, and Pakistan used the N-CAP Process to focus on data-to-action, coalition strengthening, and surveillance, respectively. While each country's outcomes were unique and context-specific, common themes emerged, including health workforce, health information, health financing, and leadership and governance, all of which contribute to health system strengthening in different ways.

The N-CAP Process effectively creates structured, multisectoral recommendations and actionable plans to increase national capacity to address public health threats, such as NCDs. By facilitating comprehensive assessments and fostering governmental and multisectoral engagement, the N-CAP Process serves as an adaptable resource for countries and other regions grappling with similar public health challenges.