Enhancing Non-Communicable Disease Control: Implementation Experiences of the Ser- vice with Care and Compassion Initiative Across Four Districts in Bhutan

Abstract

Noncommunicable diseases (NCDs) are a leading cause of death globally, responsible for 74% of all deaths, with a major impact on low- and middle-income countries. In Bhutan, NCDs accounted for nearly 69% of deaths in 2016, with cardiovascular diseases being the most significant contributor. Despite whole of government and society approach, the incidence of NCDs, such as hypertension and diabetes are on the rising trends, with many cases undiagnosed and poorly managed. To address this, Bhutan implemented the WHO Package of Essential Non-communicable Disease (PEN) interventions, later enhanced and rebranded as the Service with Care and Compassion Initiatives (SCCI) in 2021. The SCCI employs a 7Rs and 3Cs framework to improve NCD care at the primary healthcare level, focusing on holistic and patient-centered approaches. This paper studies the implementation of the SCCI in four Bhutanese districts—Bumthang, Mongar, Sarpang, and Zhemgang—highlighting the approaches utilized for the prevention and control of NCDs through this comprehensive framework of 7Rs and 3Cs.