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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 yearCountryAim of intervention/policyTarget populationIntervention/policy characteristicsNCD(s) addressedHow intervention/policy was measuredOutcomes of intervention / policy* (excerpts from abstracts)Implementing organization
Ballout et al. (2018) [22]Jordan, Lebanon, West Bank, GazaImprove quality of all service with attention to increase in NCD burdenPalestinian refugeesPHC reform, e-health (EMR) system, appointment system and Family Health Teams.NCDsDaily consultations, physician satisfaction, waiting time for patient registration, antibiotic prescription ratePhysician'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]JordanIdentify cardiovascular disease risk among patient populationSyrian refugees and JordaniansCardiovascular disease risk assessment and management tool for physicians in outpatient NCD clinics.Cardiovascular diseaseMixed methods: demographics, laboratory testing, risk factor measurements, prescribing behavior23.3% 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]LebanonImprove quality and continuity of care, health literacy, mobility of medical records and health outcomes.Syrian refugees, LebaneseTreatment 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 diabetesClinical measurements, patient-provider interaction, medication prescription and useRecording 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]IranMake dialysis and kidney transplantation available to refugeesAfghan refugees, IraniansIntegration of refugees into national dialysis and renal transplant program.End-stage renal diseaseDescriptive analysis: # on dialysis, # undergone transplantation, nationality of donors and recipientsOutcomes were not measuredTransplantation Unit, Hashemi Nejad Kidney Hospital
Khader et al. (2012) [23]JordanInform and improve the quality of health servicesPalestinian refugeesCohort monitoring of hypertension patients using e-healthHypertensionDescriptive analysis of routine program data: number of patients, patient demographics, clinical measurementsOutcome 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]JordanInform and improve the quality of health servicesPalestinian refugeesCohort monitoring of diabetes patients using e-healthDiabetesDescriptive analysis of routine program data: number of patients, patient demographics, clinical measurementsOutcome 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]JordanPrevent diabetes among high-risk patients attending clinic for other illnessesSyrian, Palestinian, Iraqi refugees and JordaniansComputer assisted diabetes risk assessment & self-administered motivational interviewing module with one-month telephone follow-up by a nurse.Type II diabetesIntervention was not measuredOutcomes were not measuredInstitute of Famiy Health (IFH); Noor Al Hussein Foundation; UC Irvine
Saab et al. (2018) [21]LebanonProvide care free of charge for patients and familiesDisplaced children: Syrian, Palestinian. Non-displaced: Families traveling from Iraq and Syria. Lebanese children.Funding scheme to support displaced children with cancer.CancerDescriptive 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, GazaTo encourage behavior change among health center patientsPalestinian refugeesEducation, cooking and exercise sessions for patients with type I and II diabetes from 8 health centersType I and Type II diabetesNon-control interventional descriptive study: Analysis of weight, BMI, waist circumference, blood sugar, blood pressure, cholesterol and patient knowledge and behaviorSignificant reductions in body measures (i.e., BMI) and biomarkers (i.e., blood pressure)United Nations Relief and Works Agency
Sethi et al. (2017) [26]LebanonImplement community based primary care for refugeesSyrian refugeesProvide community-based primary care and health promotion through Refugee Outreach Volunteers (also known as CHWs)Hypertension, diabetesSummary 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 educationOutcomes were not measuredMedical Teams International
Spiegel et al. (2014) [20]Jordan, SyriaProvide funding for refugees with serious medical conditionsRegistered 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).CancerDescriptive analysis: demographics, types of cancers, approvals and funding, reasons for denialOutcomes were not measuredUnited Nations Relief and Works Agency