Title page

Contents

Acknowledgements 5

Executive Summary 8

1. Introduction: Burden of Non-Communicable Diseases and Investments in Their Management 10

1.1. Growing Burden of Non-Communicable Diseases 10

1.2. Gaps in Management of NCDs 11

1.3. World Bank Projects Supporting Improved NCD Management 13

2. Conceptual Frameworks and Design of the NCD Assessment Tool 18

2.1. Scope of Assessment Tool 18

2.2. Conceptual Framework for the Assessment Tool 19

2.2.1. WHO Operational Framework for Primary Health Care 19

2.2.2. Chronic Care Model 20

2.3. Development of Best Practices for Strengthening NCD Management 21

2.4. Framework for Reporting Results on NCD Management 27

3. Conducting the Assessment 31

3.1. Gathering Information for the NCD Assessment 31

3.1.1. Preparation for Assessment 31

3.1.2. Desk-Based Review 31

3.1.3. Key Informant Interviews 34

3.1.4. Site Visits 35

3.2. Synthesis and Interpretation of Results 38

3.2.1. Evaluation Metric 38

3.2.2. How to Use the Tool 38

Annex 1 - Technical Details of Best Practices 39

References 59

Table 1. Examples of Recent World Bank NCD Projects 15

Table 2. List of Best Practices for NCD Management in PHC 23

Table 3. Primary Health Care Result Indicators for NCD Management 29

Table 4. Resources for Desk-Based Review for Assessment 32

Table 5. List of Data Information Sources for Each Best Practice 35

Figure 1. Leading Causes of Death by Disease Group 11

Figure 2. Number and dollar amount of new World Bank health sector projects with NCD-related activities, 2016-2020 13

Figure 3. Number and dollar amount of new World Bank health sector projects with NCD-related activities, 2016-2020 14

Figure 4. World Bank Project Cycle 16

Figure 5. WHO Operational Framework for Primary Health Care(PHC) 19

Figure 6. Chronic Care Model(CCM) 21

Figure 7. Indicators to Monitor PHC Results for NCD Management Along a Disease Continuum 28

Boxes

Box 1. Example of NCD-related project development objective(PDO) and key performance indicators(KPIs) drawn from a World Bank project 14

Box 2. Guidance Documents for Identifying Clinical Interventions Appropriate in Low- and Middle-Income Countries 22

Box 3. Dimensions of Quality 27