Hypertension (HTN) poses a significant global public health challenge, contributing to approximately 13.5% of premature deaths, 54% of incident strokes, and 47% of incident coronary heart disease cases worldwide.(1) In Nepal, HTN prevalence among adults is 25% (2), similar to the global average, but a larger proportion (44%) remain unaware of their condition. (3) To address this issue, Nepal has implemented the Package of Essential Non-Communicable Diseases (PEN) Implementation Plan in line with the Multi-sectoral Action Plan for NCD prevention and control.(4) Studies on the implementation of PEN demonstrate barriers at multiple levels that can not be addressed in just health facility-based service system. In response to multi-level implementation barriers, this study will respond to an urgent need for cost-effective evidence-based HTN control strategies in low-resource settings, particularly reaching the marginalized and disadvantaged population. The study aims to conduct a type III hybrid implementation effectiveness study with two primary objectives. First, it will assess the implementation outcomes of the Female Community Health Volunteers (FCHVs) implementation strategy at various levels using the RE-AIM framework. Secondly, it will examine the effectiveness of the FCHVs strategy compared to facility-based PEN through a pre-post intervention trial, specifically focusing on systolic blood pressure. The study will support Nepal's national NCD priorities. The FCHVs will deliver health education and promotion activities, forming peer groups. Employing a mixed-method approach, the research will employ a cluster randomized controlled trial among 350 participants, collected quantitative data on various implementation dimensions in the intervention arm, supplemented with in-depth interviews and focus group discussions with patients and FCHVs to understand implementation outcomes. Qualitative tracking logs will be maintained to document interactions with FCHVs and healthcare workers. The intervention strategy involves training Female Community Health Volunteers (FCHVs) in health facilities to address hypertension (HTN) in Nepal. The implementation bundle consists of several components: FCHVs will undergo comprehensive training covering mass screening, counseling, medication compliance, self-care, and referrals to healthcare facilities. Mass screening events will be conducted by FCHVs in collaboration with healthcare facility in-charges to identify individuals with hypertension, forming the FCHV-HTN group. Monthly sessions will be held with the FCHV-HTN group, focusing on hypertension discussions, BP log reviews, addressing challenges, and encouraging family involvement. Spouses or adult caretakers will also be invited to promote a supportive environment. FCHVs will have monthly meetings to share experiences, challenges, and refer non-adherent or uncontrolled HTN patients to healthcare facilities with monthly reports and BP logs. This intervention aims to enhance hypertension prevention and management, fostering active community engagement and effective healthcare coordination. The findings of the study will be shared in a comprehensive and inclusive approach, empowering the community with valuable knowledge, fostering evidence-based healthcare practices, and contributing to the advancement of hypertension management strategies in our community and beyond.