To identify the underlying national policy planning and implementation strategies related to PHC strengthening for NCD prevention and control, we applied an inductive coding approach by two steps.

To ensure the completeness of this search strategy, we conducted two additional searches on the same websites, each time using one of the two specific NCD conditions- Gao Xue Ya (hypertension) and Tang Niao Bing (diabetes)-as keyword, both of which are predominant NCD conditions in China. In the final step, an expanded snowballing search was conducted by reviewing references to other policies in the remaining records. Second, the search records were merged, and duplicates were excluded, first from within the same ministry and then across different ministries. First, we performed two keyword searches on each ministry's website, each time using one of the two Chinese-character keywords: Man Xing Bing (NCDs) and Man Bing (a common contraction for NCDs in Chinese). A three-step alternative approach was applied to guide the search. For example, there was no permission for Boolean operators, and keywords were limited to a maximum of three Chinese characters. The document search functions built in the national government official websites were limited. KeywordsĪbbreviations: NCD ( Non-communicable disease), CVD ( Cardiovascular disease), PHC ( Primary health care), WHO ( World Health Organization), LMICs ( Low-and middle-income countries)

We recommend future policies to facilitate multi-sectoral collaboration, enhance community engagement, and improve performance evaluation mechanisms. Over the past decade, China continues to demonstrate its policy commitment to strengthen the PHC system for NCD prevention and control. Compared with WHO recommendations, several gaps remain, including lack of emphasis on multi-sectoral collaboration, underuse of non-health-professionals, and lack of quality-oriented PHC services evaluations. Several areas showed to have strong policy support, including service delivery, health financing, and leadership/governance. Thematic content analysis was performed, and fourteen ‘major policy initiatives’ were identified, including the basic health insurance schemes and essential public health services. Policy documents from official websites of China's State Council and 20 affiliated ministries were screened, where 151 out of 1,799 were included. This study aims to review China's national policies related to non-communicable disease (NCD) prevention and control at the primary health care (PHC) level since China's 2009 health system reform.

The Lancet Regional Health – Western Pacific.

The Lancet Regional Health – Southeast Asia.

The Lancet Gastroenterology & Hepatology.

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