Noncommunicable diseases (NCDs), such as cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes, are responsible for nearly one-third of deaths worldwide, the equivalent of 41 million people per year. In 2015, world leaders committed to meeting the United Nations’ Sustainable Development Goal (SDG) target 3.4 to reduce premature mortality from NCDs by one-third by 2030. However, few countries are on track to meet this target, and without immediate action, many will fall short. New approaches and tools are needed to help countries develop and strengthen their responses to better address NCDs.
The facilitator-led Noncommunicable Diseases Capacity Assessment and Planning (N-CAP) Process is a tool driven by ministries of health who collaborate with other key governmental and nongovernmental stakeholders to assess, prioritize, and plan how to improve national capacity to address NCDs and population health. It is designed to engage multisectoral stakeholders to align NCD efforts and promote collaboration to achieve more sustainable and impactful progress. The N-CAP Process is not intended to address specific diseases but rather to look at collective efforts and capacity to address NCDs with outputs that can inform national efforts to function more effectively.
The N-CAP Process includes three distinct activities:
- Stakeholder Mapping is completed by facilitators to identify key NCD stakeholders. The results inform the selection of participants for the SWOT and N-CAP Workshops.
- Strengths, Weaknesses, Opportunities, and Threats (SWOT) Workshop is a facilitator-led workshop to understand the landscape of NCDs in the country. The results inform the selection of critical NCD areas that can be addressed in the N-CAP Workshop.
- N-CAP Workshop is a facilitator-led workshop to assess, prioritize, and plan how to improve the country’s capacity in the identified critical NCD areas.
Reports are created after each activity is completed and can inform future efforts to develop a robust, comprehensive, technical plan to address NCDs.
There are numerous materials that are used throughout the N-CAP Process. These materials are summarized below:
- Standard Operating Procedures (SOP): The N-CAP Process SOP provides standardized procedures for trained facilitators and recorders to conduct the activities of the N-CAP Process. The SOP comprises four modules: Introduction and Preparation, Stakeholder Mapping, SWOT Workshop, and N-CAP Workshop.
- N-CAP Process Activity Report Templates: Each N-CAP Process activity concludes with a summary report. The following report templates are to be used by facilitators: Stakeholder Mapping Report, SWOT Workshop Report, and N-CAP Process Report.
- N-CAP Workshop Forms: Various forms are used during the N-CAP Workshop to record the discussion. These include: Assessment Form, Prioritization and Planning Form, and External Evaluator Form.
- Summary of the N-CAP Process: A one-page, high-level summary document of the N-CAP Process.
- N-CAP Process Background and Description Presentation: A PowerPoint presentation that summarizes the N-CAP Process and is used during the SWOT and N-CAP Workshops.
N-CAP Process Discussion Guides*
Discussion Guides are a tool used by facilitators to lead customized, in-depth discussions during the N-CAP Workshop. They use the conceptual framework of a maturity model to describe the different levels of progress (Beginning, Progressing, Advanced, and Leading Edge) within a critical NCD area and include six domains (Strategic Direction, Systems, Resources, Quality, Engagement, and Impact), which are broad categories that should be considered when assessing the level of progress and developing the plan for addressing NCDs.
Available Discussion Guides are organized into seven themes relevant to common issues faced in strengthening NCD efforts. These include: Coalitions, Evidence-Informed Action, General NCD Efforts, Health Communications, Multisectoral Action, Strategic Data Collection and Analysis, and Surveillance.
*Find these materials in the sidebar for download.
Watch Dr. Patricia Richter of the U.S. CDC describe how the N-CAP Process can help countries around the world strengthen their capacity to address NCDs.
N-CAP Process Facilitator and Recorder Training Course:
The N-CAP Process is led by trained facilitators and recorders who lead the stakeholder mapping and guide and record discussions during the SWOT and N-CAP Workshops. Potential facilitators/recorders are often staff from regional public health networks and national public health institutes or experienced staff or alumnae from the field epidemiology training program (FETP) networks. Given their roles and responsibilities, all facilitators and recorders are required to complete the N-CAP Process Facilitator and Recorder Training Course prior to implementation of the activities.
The N-CAP Process was developed by the United States Centers for Disease Control and Prevention (U.S. CDC) in collaboration with Global Health Development | Eastern Mediterranean Public Health Network (GHD|EMPHNET), and the International Association of National Public Health Institutes (IANPHI).Contributing individuals include: Meredith Kruse (Alexton Inc.), Shelley Braxton, Dennis Jarvis, Patricia Richter, and Sophie Lobanov-Rostovsky of the U.S. CDC, Randa Saad, Yousef Khader, Ruba Al-Souri, and Lara Kufoof of GHD|EMPHNET, and Sue Binder of IANPHI. Development of these materials was supported by GHD|EMPHNET, via Cooperative Agreement number NU2HGH000039, and IANPHI, via Cooperative Agreement number 9NU14GH001238, both funded by the U.S. CDC.
We would like to acknowledge GHD|EMPHNET Headquarters and the Royal Health Awareness Society for piloting the first N-CAP Process in Jordan in 2021 and Drs Bushra Al Naser and Suha Al Naser for facilitating and recording the second N-CAP Process pilot in Iraq in 2022.
The views presented in the N-CAP Process materials and e-learning course do not necessarily represent the official views of the U.S. CDC, GHD|EMPHNET, IANPHI, the Task Force for Global Health, Inc., or TEPHINET. Articles, journals, and databases are for instructive or identification purposes only and do not imply endorsement.