Behavioral Science and Noncommunicable Diseases in Low- and Middle-Income Countries

Rapid population ageing has made chronic noncommunicable diseases (NCDs) the leading cause of illness and death in many low- and middle-income countries (LMICs). Despite the growing importance of NCDs, most individuals with NCDs are either undiagnosed or diagnosed but ineffectively managed. In this chapter, we frame poor NCD management from the perspective of both clinicians and patients and explore the ways that behavioral science can inform solutions to improve the management of NCDs in LMICs. We first outline how differences in the clinical presentation and treatment approaches between NCDs and infectious conditions may create behavioral challenges that negatively impact the quality of NCD care provided by clinicians and the preventive health actions required by patients to manage NCDs. We describe several behavioral biases and systems-level barriers that clinicians and patients face in effectively managing NCDs, with a focus on mental models, heuristics, habits, and health-systems frictions. We then survey interventions that target these barriers, summarizing current evidence of their effectiveness. We conclude by discussing critical gaps in knowledge and opportunities for leveraging behavioral science approaches to improve NCD outcomes in LMICs.