Implementation of the World Health Organization’s Package of Essential Noncommunicable Disease Interventions: an overview of reviews

Abstract

Objectives To synthesize the evidence on the implementation of the World Health Organization’s Package of Essential Noncommunicable Disease Interventions (WHO PEN). Methods This narrative overview of reviews draws on evidence from systematic reviews and other review articles. Results The findings reveal substantial gaps and challenges in public primary health facilities across many low- and middle-income countries, particularly in workforce capacity and the availability of essential medicines, diagnostics, and equipment. Several delivery strategies—such as high-risk population screening, task-shifting to non-physician health workers, team-based care, integrated HIV-NCD services, and the use of community pharmacies—were shown to effectively support WHO PEN implementation and expand access to NCD services. Strengthening the organization and resourcing of healthcare teams across system levels is essential. Additional promising approaches include leveraging existing service platforms, reinforcing district hospitals, adopting more patient-centered and prevention-oriented models within traditionally hospital-centric systems, and improving quality of care. Conclusion WHO PEN and similar strategies can improve NCD service delivery and outcomes, but sustained investments, context-specific adaptations, and longer-term evaluations are needed to overcome persistent implementation barriers.