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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


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.


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]


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]


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]


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]


Inform and improve the quality of health services

Palestinian refugees

Cohort monitoring of hypertension patients using e-health


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]


Inform and improve the quality of health services

Palestinian refugees

Cohort monitoring of diabetes patients using e-health


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]


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]


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.


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]


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).


Descriptive analysis: demographics, types of cancers, approvals and funding, reasons for denial

Outcomes were not measured

United Nations Relief and Works Agency