Mahankal Chaur

Hypertension and diabetes are major health challenges worldwide, leading to significant deaths and complications like stroke, heart disease, and kidney failure. In Nepal, these conditions are common, often undiagnosed or poorly managed, especially among marginalized populations. This research evaluates a community-based approach using Female Community Health Volunteers FCHVs to improve integrated management of hypertension and diabetes compared to standard facility-based care, focusing on both implementation and health outcomes over 12 months. The study is a cluster randomized controlled trial in 12 health facilities in Namobuddha Municipality, Nepal. The intervention group involves FCHVs trained for three days to screen, counsel, monitor blood pressure and blood sugar, form peer groups, and coordinate care including home visits for those unable to attend group sessions. The control group receives regular facility-based care without additional group support. Monthly group meetings and referrals for uncontrolled cases are key components of the intervention. Participants, all adults aged 30 or older with hypertension and at risk or diagnosed with diabetes, will be followed for 12 months. Data collection includes blood pressure and glycated hemoglobin measurements, lifestyle questionnaires, medication adherence checks, and qualitative interviews. FCHVs will track activities monthly, and researchers will assess reach, adoption, implementation, and maintenance of the program, alongside health outcomes like blood pressure and blood sugar control.