title: Process, rationale, and interventions of Pakistan's National Action Plan on Chronic Diseases.
abstract: Most developing countries do not comprehensively address chronic diseases as part of their health agendas because of lack of resources, limited capacity within the health system, and the threat that the institution of national-level programs will weaken local health systems and compete with other health issues. An integrated partnership-based approach, however, could obviate some of these obstacles. In Pakistan, a tripartite public-private partnership was developed among the Ministry of Health, the nongovernmental organization (NGO) Heartfile, and World Health Organization. This was the first time an NGO participated in a national health program; NGOs typically assume a contractual role. The partnership developed a national integrated plan for health promotion and the prevention and control of noncommunicable diseases (NCDs), which as of January 2006 is in the first stage of implementation. This plan, called the National Action Plan on NCD Prevention, Control, and Health Promotion (NAP-NCD), was released on May 12, 2004, and attempts to obviate the challenges associated with addressing chronic diseases in countries with limited resources. By developing an integrated approach to chronic diseases at several levels, capitalizing on the strengths of partnerships, building on existing efforts, and focusing primary health care on chronic disease prevention, the NAP-NCD aims to mitigate the effects of national-level programs on local resources. The impact of the NAP-NCD on population outcomes can only be assessed over time. However, this article details the plan's process, its perceived merits, and its limitations in addition to discussing challenges with its implementation, highlighting the value of such partnerships in facilitating the missions and mandates of participating agencies, and suggesting options for generalizability.
authors.affiliation: Heartfile, 1 Park Rd, Islamabad, Pakistan. sania@heartfile.org
authors.forename: Sania
authors.initials: S
authors.lastname: Nishtar
authors.forename: Khalif Mohamud
authors.initials: KM
authors.lastname: Bile
authors.forename: Ashfaq
authors.initials: A
authors.lastname: Ahmed
authors.forename: Azhar M A
authors.initials: AM
authors.lastname: Faruqui
authors.forename: Zafar
authors.initials: Z
authors.lastname: Mirza
authors.forename: Samad
authors.initials: S
authors.lastname: Shera
authors.forename: Abdul
authors.initials: A
authors.lastname: Ghaffar
authors.forename: Fareed A
authors.initials: FA
authors.lastname: Minhas
authors.forename: Aslam
authors.initials: A
authors.lastname: Khan
authors.forename: Naeem A
authors.initials: NA
authors.lastname: Jaffery
authors.forename: Majid
authors.initials: M
authors.lastname: Rajput
authors.forename: Yasir A
authors.initials: YA
authors.lastname: Mirza
authors.forename: Mohammad
authors.initials: M
authors.lastname: Aslam
authors.forename: Ejaz
authors.initials: E
authors.lastname: Rahim
mesh_terms: D000328:Adult; D002908:Chronic Disease / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration / Q000639:trends*; D010154:Pakistan / Q000453:epidemiology; D011314:Preventive Health Services / Q000458:organization & administration / Q000639:trends*