Assessment of non-communicable diseases risk factors knowledge, and prevention practices among non-physician healthcare workers in selected primary and secondary hospitals of northern Bangladesh: a facility-based cross-sectional study

Background: Non-communicable diseases (NCDs) pose a growing challenge for health systems in low- and middle-income countries (LMICs), where non-physician healthcare workers (NP-HCWs) constitute a substantial proportion of the frontline workforce engaged in prevention and health promotion. However, evidence on NP-HCWs’ knowledge of NCD risk factors and preventive practices in Bangladesh remains limited. Methods: This facility based cross sectional study assessed NCD related knowledge and preventive practices among NP-HCWs, including nurses, community health care providers, health assistants, and support staff, across two secondary and six primary level government healthcare facilities in Nilphamari district, northern Bangladesh, between August 2023 and January 2024. Data were collected using a structured, pretested questionnaire informed by a modified WHO STEPS approach and analysed using descriptive statistics and multivariable logistic regression. Results: Most NP-HCWs were female (59%) with a mean age of 37.1± 9.7 years. Overall, 70% of NP-HCWs demonstrated good knowledge (≥80%), though gaps existed. Over 45% did not recognize NCDs as non-infectious, and 33% of nurses believed they were not preventable. However, only 13% of NP-HCWs practiced stress management, and 27% underwent regular health check-ups. Graduates and those with higher educational degrees were a significant predictor of good preventive practice (aOR: 4.9; 95% CI: 1.13–21.33; p = 0.03). Support staff consistently showed lower odds for both good knowledge and practices in unadjusted analyses. Conclusion: These findings show that while NP HCWs generally have good knowledge of NCDs, preventive practices remain limited. Targeted, cadre specific interventions are needed to improve NCD related knowledge and preventive behaviours among NP HCWs.