Abstract
BackgroundThe increasing caseload of non-communicable diseases (NCDs) in displaced populations poses new challenges for humanitarian agencies and host country governments in the provision of health care, diagnostics and medications. This study aimed to characterise the prevalence of NCDs and better understand issues related to accessing care among Yazidis and other minority groups displaced by ISIS and currently residing in camps in the Kurdistan Region of Iraq.MethodsThe study covered 13 camps managed by the Kurdish Board of Relief and Humanitarian Affairs. A systematic random sample of 1300 households with a total of 8360 members were interviewed between November and December 2015. Respondents were asked whether any household members had been previously diagnosed by a health provider with one or more of four common NCDs: hypertension, diabetes, cardiovascular disease and musculoskeletal conditions. For each household member with an NCD diagnosis, access to health care and medications were queried.ResultsNearly one-third of households had at least one member who had been previously diagnosed with one or more of the four NCDs included in this study. Hypertension had the highest prevalence (19.4%; CI: 17.0–22.0), followed by musculoskeletal conditions (13.5%; CI: 11.4–15.8), diabetes (9.7%; CI: 8.0–11.7) and cardiovascular disease (6.3%; CI: 4.8–8.1). Individual NCD prevalence and multimorbidity increased significantly with age. Of those with an NCD diagnosis, 92.9% (CI: 88.9–95.5) had seen a health provider for this condition in the 3 months preceding the survey. In the majority of cases, care was sought from private clinics or hospitals rather than from the camp primary health care clinics. Despite the frequent access to health providers, 40.0% (CI: 34.4–46.0) were not taking prescribed medications, costs being the primary reason cited.ConclusionNew strategies are needed to strengthen health care provision for displaced persons with NCDs and ensure access to affordable medications.
Highlights
The increasing caseload of non-communicable diseases (NCDs) in displaced populations poses new challenges for humanitarian agencies and host country governments in the provision of health care, diagnostics and medications
This study aims to characterise the prevalence of NCDs among the displaced population residing in Board of Relief and Humanitarian Affairs (BRHA) camps and better understand issues of health care access
All households had been displaced from their homes in Nineveh governorate during the Islamic State of Iraq and Syria (ISIS) attack, and 80.0% (CI: 77.9–81.9) were Yazidi
Summary
The increasing caseload of non-communicable diseases (NCDs) in displaced populations poses new challenges for humanitarian agencies and host country governments in the provision of health care, diagnostics and medications. Health care for displaced populations has traditionally focused on maternal and child care and treatment of communicable diseases [1] While these traditional health priorities remain relevant, demographic and lifestyle changes are increasing the burden of noncommunicable diseases (NCDs) in populations worldwide. This epidemiological shift poses new challenges for humanitarian agencies and host country governments. In the absence of regular care and access to medications, NCDs may result in complications requiring costly specialised care and have the potential to seriously compromise both quality of life and life expectancy [2, 3]. These required resources are often not available in health services for displaced populations
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