Piloting paediatric NCD care model

In a major step toward addressing non-communicable diseases (NCDs) among children, Bangladesh has successfully piloted its first evidence-based paediatric NCD service delivery model at the primary healthcare level. This initiative, led by icddr,b in collaboration with the Directorate General of Health Services (DGHS) and supported by UNICEF Bangladesh, aims to integrate paediatric NCD services into the national health system, according to the press release.

The pilot study titled 'Designing and Piloting a Paediatric NCD Service Model for Children and Adolescents at Primary Health Care Facilities in Bangladesh' identified six priority childhood NCDs in the country: bronchial asthma, congenital heart disease, epilepsy, thalassaemia, kidney disease, and type 1 diabetes.

Unlike global models that often focus on diseases like rheumatic heart disease or sickle cell disease—more prevalent in Sub-Saharan Africa—this model is tailored to Bangladesh's unique health landscape. Using evidence gathered through the study, the government developed the first National Treatment Protocol for paediatric NCDs in 2024.

The service model was launched in February 2025 across 22 facilities, including 12 Upazila Health Complexes in Kishoreganj, eight in Bagerhat, and two district hospitals. It is designed to deliver standardised care to children aged 0 to 17 years with NCDs. Under this study, key gaps in primary healthcare facilities for managing childhood NCDs were assessed. Training modules were developed for healthcare professionals, including doctors, nurses, Sub-Assistant Community Medical Officers (SACMOs), and community healthcare workers. Social and Behaviour Change Communication (SBCC) materials were developed, while a registration system for tracking patient records and a digital health platform for generating monthly reports from each facility were also introduced. Within the first seven weeks, 385 children were diagnosed and enrolled. Bronchial asthma was the most common condition (36.6%), followed by thalassaemia and iron deficiency anaemia (27.5%), congenital heart disease (19.1%), epilepsy (13.6%), nephrotic syndrome (2.2%), and type 1 diabetes (1%). Around 8% were referred to higher-level centres for specialised care.

To strengthen healthcare delivery, more than 200 professionals—including doctors, nurses, and Sub-Assistant Community Medical Officers (SACMOs)—along with over 500 community healthcare providers (CHCPs), were trained. The initiative also developed behaviour change communication materials to increase awareness and implemented a registration and digital tracking system to monitor patient data and progress.

Experts say the model is both feasible and acceptable for implementation at the primary healthcare level. Key gaps in the system were addressed, such as training needs, patient tracking, and awareness at the community level.

With rising rates of chronic illnesses among children, this pilot offers hope for a more inclusive and responsive healthcare system in Bangladesh—bringing the country a step closer to achieving universal health coverage and sustainable development goals.

Source: icddr,b