Readiness of primary health care facilities for non-communicable disease services in Port Sudan, Sudan: a WHO Service Availability and Readiness Assessment (SARA) cross-sectional study

Background: Non-communicable diseases (NCDs) represent a major challenge to sustainable development and an alarming public health crisis in Sudan, exacerbated by a severely collapsed healthcare system. Primary health care (PHC) facilities play a central role in NCD prevention and management; yet, evidence on their readiness in Port Sudan is limited. This study assessed the readiness of PHC facilities in Port Sudan to manage or provide services for diabetes mellitus, cardiovascular diseases, and chronic respiratory diseases. Methods: A descriptive cross-sectional study was conducted in 25 Ministry of Health PHC facilities across the Middle, Eastern, and Southern sectors of Port Sudan between September and October 2025. Facility readiness was assessed using selected domains of the World Health Organization Service Availability and Readiness Assessment (SARA) tool, covering general and NCD-specific services. Descriptive statistics summarized facility characteristics and readiness scores. Multiple linear regression analyses examined associations between readiness scores and facility sector, Ministry of Health classification, and urbanization status. Statistical significance was set at p  < 0.05. Results: Most facilities were in urban areas (92%) and primarily provided outpatient services (88%). General service readiness revealed major gaps: electricity and improved water sources were available in only 40% of facilities, and none of them had communication equipment. Basic equipment readiness was comparatively stronger. Overall NCD services readiness was critically low, with service availability for diabetes mellitus in 52% of facilities, chronic respiratory diseases in 48%, and cardiovascular diseases in only 28%. Availability of clinical guidelines and trained staff was limited across all NCD categories. Essential medications for NCD management were poorly stocked, particularly antihypertensives and insulin, reflecting supply chain fragility. Regression analysis showed no significant predictors of NCD readiness by sector or urbanization; however, Family Health Reference Centers had significantly higher general readiness scores. Conclusions: PHC facilities in Port Sudan are severely underprepared to deliver essential NCD services. Urgent policy interventions are needed to address major deficiencies in infrastructure, human resources, diagnostics, and essential medications to strengthen the PHC system capacity and improve NCD service delivery in such fragile health system settings.