# Community-Level Screening and Referral Guidelines for Major Non-Communicable Diseases at Primary Healthcare Settings: From Development to Application at the Multi-site ‘NCDs Mega-Campaign 2024’ in Kathmandu Metropolitan City, Nepal

## TL;DR

This paper describes a community-based screening program for hypertension, diabetes, and CKD in Nepal, implemented across 256 sites in Kathmandu in 2024.

## Contribution

The study introduces structured, community-focused guidelines for NCD screening and referral in primary healthcare settings in Nepal.

## Key findings

- A three-phase program was developed and applied across 256 sites in Kathmandu for NCD screening.
- The initiative aimed to address the rising undiagnosed NCD burden in lower- and middle-income countries.
- The guidelines were designed to improve people-centric strategies and community-focused interventions.

## Abstract

Non-communicable diseases (NCDs), mainly cardiovascular conditions like hypertension, diabetes, and chronic kidney disease (CKD) are the major causes of morbidities and mortalities worldwide, with lower- and middle-income countries (LMICs) bearing the highest burden. As the UN 25*25 targets near their final year and the Sustainable Development Goals approach their last trimester, NCD cases continue to rise, leaving a significant undiagnosed population submerged in the communities and households. In Nepal, a few initiatives have been made at the health-facility level over the past decade. However, they lack people-centric strategies and community-focused intervention with appropriate working guidelines. This article outlines the three-phase development of a community-level screening program in Kathmandu Metropolitan City, providing structured guidelines for health workers to screen and appropriately refer cases of hypertension, diabetes, and CKD, implemented during the large-scale community-based campaigns across 256 sites in Kathmandu Metropolitan in 2024.