PATH works to improve access to person-centered primary healthcare. For people living with NCDs, this is a critical approach for ensuring essential, affordable NCD services are within reach. PATH’s health systems approach focuses on three components: availability of quality data to target NCD resources, access to NCD medicines and products, and integrated NCD services at the primary care and community level.

Availability of quality NCD data

One continuing, notable area of progress in improving access to quality data and information is the NCD Navigator, which was first introduced in Kenya in 2018 in collaboration with the Kenya Ministry of Health and with the support of the Access Accelerated-PATH partnership.

“This dynamic mapping tool tracks NCD programs, producing real-time data that enables policymakers to make evidence-based decisions,” says Helen McGuire, Global NCD Program Leader at PATH. “The NCD Navigator is instrumental in aligning NCD initiatives with national strategies, a critical step in ensuring cohesive and effective healthcare planning.”

Today, the Kenya Ministry of Health uses the Navigator to inform decision making and direct the implementation of its NCD 2021 – 2026 national strategy. The Navigator was subsequently introduced in Ghana in 2020, in partnership with the Ghana Health Service.

The Navigator played a pivotal role in resource allocation discussions as part of the development of Ghana’s NCD national strategy and policy in 2022 and continues to support stakeholder coordination initiatives to optimize impact.

The Navigator has since aided a high-level mapping initiative in Myanmar, while a successful orientation of the Navigator has been completed in Ethiopia and Nigeria in partnership with the World Health Organization. 2024 promises yet more expansion for the program, including a unique collaboration with the International Olympic Committee and the WHO that will incorporate sport and physical activity indicators across five low- and middle-income countries, including Vietnam.

Access to NCD Medicines

Supply chain innovations have originated from The Journey of the Pill NCD supply chain assessments, which were another key pillar of the Access Accelerated-PATH collaboration. Assessments conducted in Ghana, Kenya, and Vietnam laid important groundwork for targeted initiatives aimed at strengthening supply chains.

In Vietnam, for example, improved forecasting and supply planning capacity is resulting in better quantification and stock management of hypertension and diabetes medicines, while a stock tracker developed with the Kenya Medical Supplies Authority is providing important insight into the flow of NCD medicines through the country’s public system, which supports the redistribution of supply and the match between supply and demand at national and sub-national levels.

The Coalition for Access to NCD Medicines and Products, supported by the Access Accelerated-PATH partnership, introduced a new NCD forecasting tool in Kenya and Uganda in 2022. Working with both ministries of health, the data collection and workshops generated costed five-year forecasts and equipped advocates with essential data and evidence to support budget requests for NCDs, while also highlighting underfunded NCD disease areas and medicines that require increased budget allocation. In 2023, the NCD forecasting tool was introduced in Ghana.

“The ministry of health noted that the preliminary findings of the NCD forecasting tool’s expansion to Ghana revealed a significant gap—six to 10 times the current allocation across NCD medicines—between current funding and what would be required to treat NCDs based on local guidelines and practices,” says McGuire.

PATH also sought to make better use of excess vaccine cold chain storage. Following a baseline assessment for the integration of insulin into the existing vaccine cold chain, PATH and the Ghana Health Service conducted a pilot implementation for cold chain integration in the Ga West Municipal District in Ghana’s Greater Accra Region in 2023.

The pilot showed that integration is feasible, particularly at lower levels of care such as health centers and community-based health services, as long as proper guidelines, training, and monitoring are in place. Ghana’s experience informed a similar baseline assessment in Uganda, opening the door to more efficient NCD medicine delivery.

Integrating NCD care at the primary care level

In Vietnam, PATH implemented a transformative approach to NCD prevention and treatment by integrating screenings for diseases like hypertension and diabetes, once only available through expensive physicals at tertiary care centers, into primary care at the community level. PATH’s primary healthcare strengthening work began in four districts of Ho Chi Minh City and has since expanded to three regions of Vietnam as part of its partnership with Access Accelerated beginning in 2019.

Over the course of the project, more than 270,000 people were screened for diabetes and hypertension—surpassing initial targets. In 2023, the PATH team worked with the Ministry of Health to develop educational and capacity building materials to support further scaling of this work throughout Vietnam.

Taking a human-centered design approach, PATH also created an app to support self-screening for disease risks, provide information on hypertension and diabetes, and link patients with health facilities.

Since its launch, the app has averaged 1,000 downloads a week. PATH has also rolled out an app designed for health workers, allowing them to access patient self-screening results as well as diagnoses, clinic visits, and treatment information.

The adaptability of PATH’s primary care model has been proven in Kenya, where the initiative included a focus on developing digital health technologies, capacity building for healthcare and community workers, and strengthening last-mile distribution of medicines. In 2023 alone, the initiative screened close to 22,000 Kenyans for hypertension and over 1,400 for diabetes, with a significant portion referred for follow-up care. Nearly 5,500 individuals were enrolled in care during the year.

Cumulatively, the project achieved remarkable results, screening 114% of the original target population and enrolling 118% of the target into care. Of those with a confirmed diagnosis, 57% remained active in care, 67% achieved controlled blood pressure, and 60% maintained controlled blood glucose levels.

“It is evident that innovation, collaboration, and community-based approaches are essential to reshaping the landscape of quality NCD care,” emphasizes McGuire. “The collective achievements in 2023 and our six-year collaboration with Access Accelerated have shown lasting impact and clearly illuminates proof points to guide the way forward. We will continue to build on these successes to advance equitable access to quality care for people living with NCDs.”