Pharmacy-based non-communicable diseases screening has high potential for reach: lessons from Rwanda

Low and middle-income countries are entering an epidemiological transition where non-communicable diseases (NCDs) increasingly contribute to disease burden. While Rwanda has one of the most robust public health systems in sub-Saharan Africa, rapid urbanization is leading to an emerging middle-class population who are at high risk for NCDs, but who also underutilize preventive care. The Goodlife Access pilot program in Rwanda screened over 9,000 individuals for diabetes, hypertension, and obesity over 18 months for free; 83% of individuals showed abnormal screening results, 90% of whom had no prior diagnosis. Pharmacy-based screenings effectively reached a high-risk, underserved population and highlights the potential of community pharmacies to amplify NCD diagnoses. While one-third of those screened returned for confirmatory testing at the pharmacy, more work is needed to bolster re-engagement, including addressing fear of confirmatory testing and potential medical treatment costs. Given the successful pilot, Goodlife Access is expanding access to NCD screening while incorporating community-based health insurance and user donations to enhance sustainability.