A Scoping Review of Noncommunicable Disease Programs Evaluation: Bridging Gaps and Improving Frameworks in Primary...

Effective evaluation is critical for improving non-communicable disease (NCD) programs. This scoping review explores evaluation methods at the primary healthcare (PHC) level, examines the evaluation process, maps key dimensions and indicators, and identifies related challenges.

The present review was conducted based on PRISMA-ScR and the Arksey and O'Malley framework. We systematically searched Web of Science, Scopus, PubMed, EMBASE, Emerald, Google Scholar, and relevant websites for studies published from January 2000 to January 2023. Eligible studies were selected using predefined criteria, and data were managed and synthesized using EndNote 8.1 and MAXQDA 2020.

A total of 50 studies were included, with most using observational studies (n = 22, 44%), particularly cross-sectional designs (n = 17, 34%). Content analysis revealed three main categories: Evaluation processes, this category covered aspects such as evaluation levels, focus, scope, approaches, methods, and capacities. Dimension and indicators, included inputs, process, outputs, outcomes, and the perspectives of health care providers and recipients. Evaluation challenges, identified challenges included information management, workforce-related issues, budget and deficiencies in the evaluation system itself.

This review offers an in-depth synthesis of evaluation methodologies applied to NCD programs within the primary healthcare context. The majority of evaluations predominantly utilized observational, cross-sectional study designs, with a primary focused on cardiovascular diseases, diabetes, and hypertension, whereas conditions such as chronic obstructive pulmonary disease and cancer received comparatively limited attention. Evaluations mainly targeted public-sector programs and service-provider perspectives. In low- and middle-income countries, studies often relied on external funding and evaluators. Evaluation efforts often prioritized outputs over inputs and processes and were further constrained by limited information systems, workforce shortages, budget limitations, and inadequate evaluation frameworks. Collectively, these findings emphasize the imperative for methodological diversification, inclusive engagement of a broader range of stakeholders, and enhancement of domestic evaluation capacities to establish more robust, comprehensive, and sustainable frameworks for monitoring and assessing NCD programs.