Strengthening health systems and service delivery for NCD prevention and control

The huge disease burden of NCDs in all countries place great pressure on the health system. The demand on the health system is further exacerbated by the increasing availability of new and expensive diagnostic and treatment options in a number of countries. Strengthening health systems is particularly important at the primary care level, where a large number of cost-effective interventions for the prevention and treatment of NCDs can be delivered – and conditions well managed at this level will reduce (but not obviate) the need for more expensive secondary and tertiary care for complex conditions. The chapter describes the six building blocks for any health system (service delivery; health workforce; health information systems; access to essential medicines, vaccines and technologies; health financing; and leadership and governance) along with challenges for improving health systems. The chapter then describes what needs to change in order to make health systems more responsive for preventing and controlling NCDs. The chapter provides examples of technical packages and tools to support integrated approaches to NCDs in primary care. The chapter concludes with a description of tools that have been developed to assess and monitor the effectiveness of health systems in their ability to respond to NCDs.