Association Between the WHO Package of Essential Non‐Communicable Disease Interventions and Clinical Outcomes Among Patients With Hypertension and Diabetes in Palestine: A Comparative Cross‐Sectional Study

Background and Aims: Non-communicable diseases (NCDs), particularly hypertension and type 2 diabetes mellitus, represent a major public health burden in Palestine. The World Health Organization's Package of Essential Non-Communicable Disease Interventions (PEN) was introduced to strengthen primary healthcare services in low-resource settings. However, evidence on its association with patient-level clinical outcomes in Palestine remains limited. This study aimed to assess the association between PEN implementation and clinical outcomes, including blood pressure, glycemic control, and disease-related complications. Methods: ) with 95% confidence intervals (CI). Results: < 0.001). The PEN approach was associated with higher odds of controlled blood pressure (AOR = 1.78, 95% CI [1.15, 2.74]) and HbA1C (AOR = 1.64, 95% CI [1.05, 2.56]), and lower odds of complications (AOR = 0.52, 95% CI [0.34, 0.79]). Patients in the PEN group also reported significantly higher healthcare utilization and adherence indicators. Conclusion: The PEN approach was associated with modest improvements in clinical outcomes, reduced complications, and enhanced healthcare utilization among patients with hypertension and diabetes in primary care settings. However, given the cross-sectional design, these findings should be interpreted as associations rather than causal effects. Further longitudinal and experimental studies are required to confirm these findings and evaluate long-term impact.