NIHR Global Health Research Centres 1: NIHR Global Health Research Centre for multiple long-term conditions A UK and low-and-middle-income-country (LMIC) partnership that aims to improve the care for people with multiple long-term conditions (MLTC) through innovative health system level interventions in India and Nepal. The proposed project will be co-led by investigators from the Public Health Foundation of India and University of Leicester in partnership with co-applicant institutions - All India Institute of Medical Sciences, Jodhpur (India), Health Related Information Dissemination Amongst Youth (India) and Kathmandu Medical College (Nepal). Patients with MLTCs in India and Nepal typically display worsened health and increased adverse outcome risk. Additionally, healthcare access is often limited in marginalized communities, and MLTC healthcare service delivery can be fragmented and inefficient. To address this, we will implement health system level interventions in Visakhapatnam (India), Jodhpur (India) and Bhaktapur and Kavrepalanchowk (Nepal). The interventions will meaningfully engage patients, their communities, and other relevant stakeholders. We will use their views to co-design a person or patient-centred care model that works for them. In addition, we will build the capacity of patients, providers, researchers, and research supporting staff to ensure that the proposed activities under the project are implemented and sustained beyond the project end date. The project activities will begin from October 2022 and end in September 2027. In the short term, we will analyse existing and new data to understand the patterns of multiple long-term conditions in both countries, how the health systems provide care and identify the best method to deliver patient-centred and responsive care for people living with these conditions. We will conduct community conversations and interviews among people living with these conditions and their caregivers, healthcare providers and the wider community to identify their experiences, needs, beliefs and living environment. We will identify “Community Champions”, who will represent people living with multiple long-term conditions, to work with us to help develop a responsive care model. In the medium term, we will propose interventions or a treatment package that respect people’s culture, beliefs, and environment and work in close partnership with the Community Champions to create a network of patients. We will test the interventions to understand if they are appropriate and adequately adapted to the context and if they could be integrated into the pre-existing health system. The interventions will use digital technology (an electronic decision support system, telemedicine) to provide care. Simultaneously, we will build the capacity of young researchers through varied educational programmes to address multiple long-term conditions and bolster institutional capacity to advance research. In the long term, we will work with the governments of India and Nepal to address multiple long-term conditions (MLTC) and embed the care model in the respective health systems to improve population health outcomes. Findings and materials developed by this collaboration will be widely disseminated and shared to improve the quality of lives of people with multiple long-term conditions, strengthen the health systems, and benefit societies and national economies.