Mahankal Chaur

Hypertension and diabetes are major health problems worldwide, causing many premature deaths and serious complications like strokes, heart disease, and kidney failure. In Nepal, hypertension affects about a quarter of adults, and diabetes affects nearly 6%, with many cases undiagnosed or poorly managed. This study aims to find effective, affordable ways to manage both conditions together in low-resource communities, focusing on marginalized groups. It uses a hybrid study design to evaluate how well a community health worker-led program works compared to standard facility-based care over 12 months. The study compares two groups: one receiving integrated management of hypertension and diabetes led by Female Community Health Volunteers (FCHVs) and frontline health workers, and the other receiving usual care at health facilities. FCHVs receive three days of training on screening, counseling, blood pressure and blood sugar monitoring, and referrals. They organize group meetings monthly for patients to support lifestyle changes, track health measures, and encourage facility visits for uncontrolled cases. The program also includes home visits for those unable to attend group sessions and close coordination with health facilities. Participants will be adults aged 30 or older with hypertension and diabetes or at risk for diabetes, living in Namobuddha Municipality, Nepal. Researchers will collect data on blood pressure, blood sugar, medication adherence, lifestyle, and quality of diet at the start, mid-point, and end of the 12-month study. They will also monitor how well the program is adopted and implemented through interviews, group discussions, and tracking tools. The study aims to measure health outcomes and understand factors affecting the program's success and sustainability.