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. 2020 Jul 22;13(1):1788262. doi: 10.1080/16549716.2020.1788262

Table 1.

NCD services at various levels of PHC in Nepal [4].

S.N. Level of health institutions District with PENα implementation District without PENα implementation
1 Health Post

  • Health education and counseling on NCD risk reduction behavior

  • Anthropometric measurements

  • Screening for hypertension, diabetes, breast cancer (examination) and cervical cancer as well as breast examination

  • Drugs for hypertension, diabetes and COPD, and referral of suspected cases of NCDs

  • Counseling on NCD risk behavior

  • Anthropometric measurements,

  • Screening for hypertension and diabetes (those with laboratory), and

  • Referral of suspected cases of NCDs
2 Primary health center All above plus: All above plus:
   

  • Screening for lipid disorders (some)

  • Early diagnosis of CVDs with the use of CVD risk prediction chart and ECG and CKDs by assessing urine protein

  • Screening for asthma and COPD including history taking, measuring peak expiratory flow rate and managing exacerbation

  • Management of acute presentation of CVDs

  • Chest rehabilitation techniques

  • Screening for diabetes, lipid disorders (some), cervical cancer as well as breast examination

  • Early diagnosis of CVDs and CKDs through ECG and urine protein

  • Management of acute presentation of CVDs

  • Drugs for hypertension, diabetes and COPD (only in health insurance implemented health facilities)
3 Primary Hospital All above plus:
   

  • Screening for lipid disorders and tests for albumin, sodium and potassium

  • Screening for breast cancer (ultrasonography)

  • Medical management of CVD cases (outpatient, inpatient and referral)
4 Province Hospital (former 50 bedded, zonal and regional hospital) All above plus:
 

  • Medical management of CVD, hyperglycemic crises and acute renal failure cases (outpatient, inpatient and intensive care)

  • Dialysis service (some)

  • Biopsy test for cancer (some)
5 Federal (Central, university and specialized hospitals) All above plus:
 

  • Medical management of cases (outpatient, inpatient, intensive and interventional therapy) and specialized tests and services

  • Renal transplant (two public and three private hospitals)

αPEN programme is implemented in 50 out of 77 districts as of 2019.