Bringing the PEN-Plus care model for chronic diseases to Zambian health services
Adapts and tests PEN-Plus care for chronic conditions at 2 Zambian hospitals.
Plain-language title generated from the registry record
Registry title: Domestication and Implementation of the PEN-Plus Clinical Model in the Zambian Health System
Key facts
- Where
- Lusaka, ZambiaSee the site
AI summary: who the study is looking for
From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.
The trial is looking for people who have a long-term non-communicable disease (a chronic illness that does not spread between people) and who agree to come back for routine follow-up visits.
- Sex
- All sexes can join.
- Disease stage
- Chronic non-communicable diseases (the record names heart disease, sickle cell disease, high blood pressure, diabetes, epilepsy, cancer and mental health disorders). No stage or severity is given.
Main reasons for not taking part
- Refusing to be followed up for routine visits
Read by machine on 9 November 2026.
Where in Zambia
- Matero First Level HospitalLusaka, ZambiaTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Centre for Infectious Disease Research in Zambia
- Trial code
- NCT07753681
- Record updated
- 7 August 2026
- Original description
Cognizant of the prevalence of complicated non communicable diseases (NCD) and the attendant capacity problems faced by the health workers in primary care settings, we propose to adapt and pilot the Package of Essential Non-communicable Diseases (PEN) Plus intervention using the Interactive Systems Framework (ISF) and then implement and monitor the impact. The ISF framework proposes and organizes several implementation strategies to achieve Evidence Based Implementation (EBI) adaptation. We will apply these strategies at 2 first level hospitals (Peri-Urban and Rural) to ensure local adaptation and work towards scaling up of the WHO-PEN Plus in the rest of Zambia. This process will be inclusive, involving a Stakeholder Consultation Group that shall include the Zambian Non-Communicable diseases and injuries (NCDI) Poverty Commission and shall report bi-annually to a Project Advisory Board (PAB) chaired by the Permanent Secretary of the Ministry of Health.Read full original descriptionShow less
PEN-Plus Initiation Grant Opportunity: Domestication and Implementation of the PEN-Plus Clinical Model in the Zambian Health System
Cognizant of the prevalence of complicated non communicable diseases (NCD) and the attendant capacity problems faced by the health workers in primary care settings, we propose to adapt and pilot the Package of Essential Non-communicable Diseases (PEN) Plus intervention using the Interactive Systems Framework (ISF) and then implement and monitor the impact. The ISF framework proposes and organizes several implementation strategies to achieve Evidence Based Implementation (EBI) adaptation. We will apply these strategies at 2 first level hospitals (Peri-Urban and Rural) to ensure local adaptation and work towards scaling up of the WHO-PEN Plus in the rest of Zambia. This process will be inclusive, involving a Stakeholder Consultation Group that shall include the Zambian Non-Communicable diseases and injuries (NCDI) Poverty Commission and shall report bi-annually to a Project Advisory Board (PAB) chaired by the Permanent Secretary of the Ministry of Health.
Inclusion: Presenting with chronic NCDs.
Exclusion: Refusing to be followed up prospectively for routine visits.