PHSSR Policy Roadmaps for Acting Early on NCDs Synthesis Report 2025

121 Acting early on NCDs The Partnership for Health System Sustainability and ResilienceDomain 2: Governance This domain assessed institutional arrangements and accountability mechanisms for NCD policy, including: Institutions : Roles and responsibilities of ministries, national committees, and regional authorities in NCD policy development and implementation Expertise and inclusivity : Involvement of professional bodies, patient organisations, and advocacy groups in policy formation and decision-making processes Data for policy formation : Availability and use of national health surveys, risk factor surveillance systems, and evidence-based policy development processes Strategy and targets : Existence, specificity, and implementation of national NCD strategies with SMART targets for prevention, diagnosis, and treatment outcomes Registries : Coverage, quality, and policy utility of disease-specific registries for cancer, cardiovascular diseases, diabetes, and respiratory conditions Crisis preparedness and response : Contingency plans for maintaining NCD services during health system shocks, including lessons from COVID-19 Domain 3: Service delivery This domain examined the organisation and delivery of NCD services across the care continuum: Guidelines and protocols : Availability, quality, and implementation of evidence-based clinical guidelines for NCD prevention, diagnosis, and management Risk assessment : Use of validated risk stratification tools, biomarkers, polygenic risk scores, and systematic identification of high-risk populations Screening : Coverage and performance of organised screening programmes for cancer, cardiovascular-metabolic conditions, kidney disease, and respiratory diseases Diagnosis and referral : Efficiency of referral systems, diagnostic capacity, waiting times for imaging and specialist assessment, and care coordination between levels Secondary and tertiary prevention : Access to treatment following diagnosis, management of multimorbidity, integrated care pathways, and monitoring for disease progression Domain 4: Financing This domain analysed financial arrangements affecting NCD prevention and care: Health spending : Overall healthcare expenditure levels, prevention spending as proportion of health budgets, and resource allocation across service types Coverage and financial barriers : Gaps in public coverage for NCD services, out-of-pocket payments, catastrophic health expenditure, and mechanisms for financial protection Financial incentives : Provider payment methods, their alignment with prevention and coordinated care objectives, and specific incentives for screening, early diagnosis, and quality improvement