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Table 3 Summary of selected studies

From: Addressing noncommunicable diseases among urban refugees in the Middle East and North Africa - a scoping review

Author and year Country Aim of intervention/policy Target population Intervention/policy characteristics NCD(s) addressed How intervention/policy was measured Outcomes of intervention / policy* (excerpts from abstracts) Implementing organization
Ballout et al. (2018) [22] Jordan, Lebanon, West Bank, Gaza Improve quality of all service with attention to increase in NCD burden Palestinian refugees PHC reform, e-health (EMR) system, appointment system and Family Health Teams. NCDs Daily consultations, physician satisfaction, waiting time for patient registration, antibiotic prescription rate Physician's daily consultations were reduced from 104 to 85. 89% of doctors expressed satisfaction concerning timesaving and efficiency of e-Health. Average wait time in registration queue decreased from 25 minutes to 12 minutes. Average registration time reduced from 6 minutes to 1.5 minutes. Average antiobiotic prescription rate decreased from 27% to 24.5% and average number of medical consultations per day decreased 104 to 85. United Nations Relief and Works Agency
Collins et al. (2017) [28] Jordan Identify cardiovascular disease risk among patient population Syrian refugees and Jordanians Cardiovascular disease risk assessment and management tool for physicians in outpatient NCD clinics. Cardiovascular disease Mixed methods: demographics, laboratory testing, risk factor measurements, prescribing behavior 23.3% of patients had a documented WHO/ISH risk score of which 65% were correct. 60.4% of patients were eligible for lipid-lowering treatment and 48.3% of these patients were prescribed it. Analysis of interviews with sixteen MSF staff identified nine explanatory themes. Medecins Sans Frontieres
Doocy et al. (2017) [25] Lebanon Improve quality and continuity of care, health literacy, mobility of medical records and health outcomes. Syrian refugees, Lebanese Treatment guidelines: Introduction of standards guidelines, training for clinicians, counseling of patients and mHealth: Patient-controlled health record, EMR & decision tool for clinicians. Hypertension, Type II diabetes Clinical measurements, patient-provider interaction, medication prescription and use Recording of BP readings and blood sugar measurements significantly decreased following the implementation of treatment guidelines. Recording of BP readings also decreased after the mHealth phase as compared with baseline. Recording of BMI reporting increased at the end of the mHealth phase from baseline and the guidelines phase. Only differences in BMI were statistically significant. Data extracted from the mHealth app showed that a higher proportion of providers offered lifestyle counseling compared with the counseling reported in patients' paper records. There were statistically significant increases in all four measures of patient-provider interaction across study phases. International Organization for Migration; International Medical Corps in 10 health centers
Ghods et al. (2005)* [27] Iran Make dialysis and kidney transplantation available to refugees Afghan refugees, Iranians Integration of refugees into national dialysis and renal transplant program. End-stage renal disease Descriptive analysis: # on dialysis, # undergone transplantation, nationality of donors and recipients Outcomes were not measured Transplantation Unit, Hashemi Nejad Kidney Hospital
Khader et al. (2012) [23] Jordan Inform and improve the quality of health services Palestinian refugees Cohort monitoring of hypertension patients using e-health Hypertension Descriptive analysis of routine program data: number of patients, patient demographics, clinical measurements Outcome analysis indicated deficiencies in several components of clinical performance related to blood pressure measurements and fasting blood glucose tests. Between 8% and 15% of patients with HT had serious complications such as cardiovascular disease and stroke. United Nations Relief and Works Agency
Khader et al. (2012) [24] Jordan Inform and improve the quality of health services Palestinian refugees Cohort monitoring of diabetes patients using e-health Diabetes Descriptive analysis of routine program data: number of patients, patient demographics, clinical measurements Outcome analysis indicated deficiencies in several components of care: measurement of blood pressure, assessments for foot care, blood tests for glucose, cholesterol and renal function. 10-20% of patients with DM in the different cohorts had serious late complications such as blindness and stroke. United Nations Relief and Works Agency
Rowther et al. (2015) [29] Jordan Prevent diabetes among high-risk patients attending clinic for other illnesses Syrian, Palestinian, Iraqi refugees and Jordanians Computer assisted diabetes risk assessment & self-administered motivational interviewing module with one-month telephone follow-up by a nurse. Type II diabetes Intervention was not measured Outcomes were not measured Institute of Famiy Health (IFH); Noor Al Hussein Foundation; UC Irvine
Saab et al. (2018) [21] Lebanon Provide care free of charge for patients and families Displaced children: Syrian, Palestinian. Non-displaced: Families traveling from Iraq and Syria. Lebanese children. Funding scheme to support displaced children with cancer. Cancer Descriptive analysis: demographics, clinical information, actual & projected budgets, outcomes (including relapse and death) 575 non-Lebanese children suspected to have cancer were evaluated. Of those, 311 received direct medical support, with 107 receiving full-treatment coverage and 204 receiving limited-workup/specialty services; the remaining 264 patients received medical consultations. American University of Beirut Medical Center; Children's Cancer Center of Lebanon Foundation; St. Jude Children's Research Hospital; American Lebanese Syrian Associated Charities
Abu Kishk et al. (2015). [30]
2018 not available
Jordan, Lebanon, West Bank, Gaza To encourage behavior change among health center patients Palestinian refugees Education, cooking and exercise sessions for patients with type I and II diabetes from 8 health centers Type I and Type II diabetes Non-control interventional descriptive study: Analysis of weight, BMI, waist circumference, blood sugar, blood pressure, cholesterol and patient knowledge and behavior Significant reductions in body measures (i.e., BMI) and biomarkers (i.e., blood pressure) United Nations Relief and Works Agency
Sethi et al. (2017) [26] Lebanon Implement community based primary care for refugees Syrian refugees Provide community-based primary care and health promotion through Refugee Outreach Volunteers (also known as CHWs) Hypertension, diabetes Summary of initial program efforts: # of visits to monitor blood pressure, capillary glucose and medication adherence; # of refugees referred to PHC and # of home visits for education Outcomes were not measured Medical Teams International
Spiegel et al. (2014) [20] Jordan, Syria Provide funding for refugees with serious medical conditions Registered refugees in Jordan and Syria. including Iraqi, Syrian, Sudanese. Funding scheme to support refugees with serious medical problems. Committee of physicians that makes clinical funding decisions. Exceptional care committees (ECC). Cancer Descriptive analysis: demographics, types of cancers, approvals and funding, reasons for denial Outcomes were not measured United Nations Relief and Works Agency