This study focuses on improving care for people with chronic non-communicable diseases (NCDs) like diabetes in Zambia. NCDs are illnesses that are not spread from person to person, such as heart disease or cancer. The study will test and use the PEN-Plus intervention, which is a special plan to treat NCDs, in two hospitals—one in a peri-urban (near city) area and another in a rural (countryside) area. The goal is to see if these clinics can help more people, especially those who are poor, get the care they need.

• Study Duration: The study involves several visits over time as it monitors the impact of the intervention.
• Location: Conducted in two first-level hospitals, one in peri-urban and one in rural settings.
• Eligibility: Must have a chronic NCD to participate; those not willing to commit to follow-up visits are excluded.

The study will also train local health workers and develop policies to help expand the program across Zambia. This work is crucial because current health facilities are not fully equipped to handle NCDs. The project aims to make health care better for everyone, especially those who need it the most.