Case management desk guideline, including lifestyle counselling mHealth training of nurses on the desk guide package Nurse WhatsApp support group Supervision of care visits (quarterly) Digital BP apparatus, glucometer and strips Treatment cards, used for clinical care (subsequently used also as research data records) Monthly funds for health workers’ telecommunication fees
| Screen/diagnose Prescribe antihypertensive Identify hypertension and/or diabetes and treat Counsel for lifestyle modification Follow-up care Focus group discussion with nurses, month 5
| Provider practice:Screen, diagnose, treat, counsel, follow-up and report as per the case management desk guideline
Patients practice:Follow-up visits Treatment Lifestyle changes as counselled, e.g., healthy eating, activity, smoking cessation
| Patients are:Screened and diagnosed as per desk guide Prescribed right drug/ dose Counselled for life-style change Followed-up and treated, that is, continuing care
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