The Package of Essential Noncommunicable Disease (PEN) interventions in Bangladesh

1 November 2016: The Package of Essential Noncommunicable Disease (PEN) is a conceptual framework for strengthening equity and efficiency of primary health care in low-resource settings. It identifies core technologies, medicines and risk prediction tools; discusses protocols required for implementation of a set of essential noncommunicable disease (NCD) interventions; develops technical and operational outlines for the integration of essential NCD interventions into primary care and for evaluation of impact. Despite the high burden of NCDs in Bangladesh, the readiness and orientation of the primary health care (PHC) system towards prevention and management of NCDs are not precisely known. Therefore, the WHO supported the Government of Bangladesh (GoB) in piloting a model PEN intervention in one of the south-western frontier sub-districts, Debhata, in Satkhira district in 2012.

A basic minimum intervention package under three strategic headings was implemented: (a) strengthening health systems through training and supply of equipment and medicines; (b) promoting medical information systems and evidence generation; and (c) creation of public awareness through observance of NCD related awareness campaigns. The pilot concluded that the basic PEN intervention is a feasible and realistic option at PHC level. Strengthening skills of health personnel and the provision of essential medicines and technologies can improve capacity of PHC system to deal with NCDs.

In light of these findings, the GoB took the initiative to scale up similar PEN intervention in a number of sub-districts. Preparatory work has been completed including planning meetings; updating training manuals for health workforce and the data recording forms; finalizing the terms of references for relevant stakeholders; and training of trainers. Implementation of the PEN intervention will certainly prove to be a worthwhile investment in strengthening NCD management capacity at the PHC level in Bangladesh.