A HEARTS-based integrated model for noncommunicable disease control in primary health care in Peru

Peru has developed and initiated the scale-up of a HEARTS-based, integrated, person-centered primary health care system to support people living with hypertension, type 2 diabetes mellitus, and chronic kidney disease. The model combines standardized clinical pathways with validated drivers, as well as maturity and performance indexes to promote evidence-based practice and continuous quality improvement across diverse primary care settings. National implementation started in 2024 through a structured capacity-building strategy and the deployment of regional facilitators to support supervision, data quality, and clinical mentoring. Early evaluation indicates progress in clinical standardization and performance monitoring, alongside persistent system-level challenges, including limited clinical training, shortages of essential medicines and diagnostics, and the absence of a unified digital registry. Despite these constraints, Peru's experience shows that integrated, protocol-driven care for noncommunicable diseases can be implemented and scaled in resource-constrained health systems, offering a pragmatic framework for other low- and middle-income countries seeking to address multimorbidity.