Neuropsychological consequences three years post-covid-19 are persistent and have great impact on everyday activities.

Non-communicable diseases (NCDs) are the leading cause of morbidity and mortality globally. In 2021, it was responsible for an estimated 43 million deaths, equivalent to 75% of non-pandemic-related deaths and 7.3 trillion cases globally. Cardiovascular diseases account for most NCD-related deaths, causing 19 million deaths in 2021, followed by cancer (10 million deaths), chronic respiratory diseases (4 million deaths), and diabetes (over 2 million deaths). Low- and middle-income countries are disproportionately affected by NCDs, accounting for 74% of global deaths. The burden of NCDs in Africa has been rapidly increasing over the past two decades. NCD-related deaths in the World Health Organization (WHO) African Region increased from 24.2% of total deaths in 2000 to 37.1% in 2019. Although infectious diseases have historically been prevalent in the region’s disease burden, there is an epidemiological transition from communicable diseases to NCDs. Indeed, in Ethiopia, more than one-third of all deaths are attributed to NCDs, driven by physical inactivity, poor dietary habits, and inadequate healthcare access. Ethiopia, a low-income country in sub-Saharan Africa, faces structural and demographic challenges that influence healthcare delivery. These include a predominantly rural population, limited healthcare infrastructure in remote areas, workforce shortages, socioeconomic disparities, and a growing epidemiological transition from communicable to NCDs. In addition, population growth and increasing urbanisation further strain the health system, limiting access to preventive services and health promotion. In response to the increasing global burden of NCDs and the shortage of skilled healthcare workers, the WHO recommends a task-shifting approach, advocating for delegating selected NCD services to community health workers (CHWs) and integrating community-based strategies for effective NCD prevention. Ethiopia launched a community health programme, known as the Health Extension Program, to enhance health promotion and health care accessibility. The programme recruits female CHWs from local communities who have at least a secondary education to complete the 1-year health extension worker (HEW) training programme. They generally work in under-resourced environments, offering primary health care services, providing lifestyle education, conducting screening (e.g. hypertension) and helping individuals navigate the healthcare system. Therefore, CHWs play a role in NCD prevention and management by supporting individuals and communities in adopting healthy behaviours. However, the capacity of CHWs and their involvement in NCD health programmes could be influenced by adequate training and experience. Providing CHWs with training and skill development opportunities will support them to provide evidence-based care and raise community awareness of the benefits of healthy behaviours. Therefore, empowering CHWs could maximise their roles in NCD health promotion and ultimately reduce the burden of NCDs.