Health workforce implications of integrating NCD prevention, screening and treatment into hospital-based MNCH services: perspectives from Kyrgyzstan, Tajikistan and Viet Nam.

Integration of non-communicable diseases (NCDs) prevention, screening and treatment into maternal, newborn and child healthcare (MNCH) services has become increasingly important as countries address the dual burden of communicable and NCDs. While global policy attention has grown, practical experiences from low- and middle-income countries on how to operationalise this integration, particularly its implications for the health workforce, remain limited.This practice paper synthesises programme learning from Kyrgyzstan, Tajikistan and Viet Nam, drawing on WHO-supported country assessments, programme reports and practitioner perspectives, with a particular focus on workforce challenges. Health workforce shortages, skills gaps, limited training capacity and uneven distribution remain major barriers to service integration in these countries. We apply Donabedian's quality improvement model, encompassing outcome, process and structure, to elaborate on these challenges. We emphasise the importance of taking a systemic perspective in addressing health workforce issues and improving the quality of care. We recognise the need for additional research in key areas that are instrumental for strengthening the health workforce, particularly for the effective integration of NCD services into MNCH and strengthening primary healthcare. Our insights aim to assist in the development of integrated programmes and to promote advancements in the research agenda for the health workforce.