Integration of Cardiovascular Disease Services within Primary Health Care Systems: Insights from South Asia

This review assesses progress towards integrating cardiovascular disease (CVD) services within primary health care (PHC) systems in South Asia. The review examines the policy landscape, existing implementation efforts, barriers and enablers to integrated care, and the impacts of these approaches on health and health service outcomes.

National policies widely prioritise integration in response to rising non-communicable disease burdens, but implementation remains uneven across countries. Our findings illustrate that both national programmes and smaller pilot initiatives demonstrate potential to improve screening, follow-up, treatment adherence, and address intermediate CVD risk factors such as blood pressure control. However, deficient referral systems and fragmented PHC delivery with limited engagement with the private sector continues to constrain progress. Evidence evaluating impacts of integrated care on CVD incidence and mortality remains limited. Integrating CVD services within PHC is a clear policy priority in the region, yet translating political commitment into effective implementation remains challenging requiring novel approaches integrating service provider networks, embedding digital and home support innovations and referral pathways. Future research should prioritise robust evaluation of the impacts on CVD morbidity and mortality.