The WHO PEN-Plus strategy builds on WHO PEN by expanding NCD services to first-level referral facilities, ensuring access to care for severe, life-threatening NCDs such as type 1 diabetes, sickle cell disease, and rheumatic heart disease. It is designed to bridge the gap between primary care and specialized hospitals, particularly in low-resource settings, by training mid-level healthcare providers, improving supply chains for essential medicines, and integrating care into district health systems. PEN-Plus ensures that patients with complex NCDs receive continuous, high-quality care, reducing premature mortality and complications.

To provide essential NCD services to alleviate the burden of unaddressed, severe NCDs among populations through decentralized, outpatient services and integrated case management in the African Region.

1. To strengthen the availability of, and access to quality care for severe NCDs in first-level referral facilities through targeted health sector policies that foster the PEN-Plus approach;
2. To improve and recognize the capacity of the health workforce, especially at district hospitals, to provide integrated care for severe NCDs;
3. To improve the availability of essential medicines and equipment for the management of severe NCDs at district hospitals.
4. To support monitoring and evaluation and research on PEN-Plus intervention