Nadine Zablith1,2, Karin Diaconu3,4, Farah Naja5, Maria El Koussa1,2, Giulia Loffreda1,6, Ibrahim Bou-Orm1,6, Shadi Saleh1,2. 1. NIHR Global Health Research Unit on Health in Situations of Fragility, Musselburgh, UK. 2. Global Health Institute, American University of Beirut, Beirut, Lebanon. 3. NIHR Global Health Research Unit on Health in Situations of Fragility, Musselburgh, UK. KDiaconu@qmu.ac.uk. 4. Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK. KDiaconu@qmu.ac.uk. 5. Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon. 6. Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK.
Abstract
BACKGROUND: Non-communicable diseases (NCD) present an increasing global health challenge, particularly for settings affected by fragility where access to care may be disrupted, and where high-quality continuous care delivery is difficult to achieve. This study documents the complex dynamics of NCD prevention and management in the fragile setting of rural Beqaa, Lebanon. METHODS: Participatory system dynamics methods were used, including 30 semi-structured interviews and three Group Model Building (GMB) workshops. Participants included health care providers offering NCD care, and Lebanese host- and Syrian refugees community members affected by NCDs. RESULTS: Participants across all groups articulated a shared complex understanding of both the structural and direct determinants behind NCD onset. Lebanese and Syrian community members further identified several barriers to health seeking, including restrictions in health coverage, limited availability of services in the Beqaa and perceptions of poor-quality care. Health providers and community members described a health system overtly focused on disease control and overwhelmed by delivery of care to people living with NCD across both communities. CONCLUSION: Participants across all groups agreed on the need for health promotion and primary prevention activities and identified priority interventions in these areas.
BACKGROUND: Non-communicable diseases (NCD) present an increasing global health challenge, particularly for settings affected by fragility where access to care may be disrupted, and where high-quality continuous care delivery is difficult to achieve. This study documents the complex dynamics of NCD prevention and management in the fragile setting of rural Beqaa, Lebanon. METHODS: Participatory system dynamics methods were used, including 30 semi-structured interviews and three Group Model Building (GMB) workshops. Participants included health care providers offering NCD care, and Lebanese host- and Syrian refugees community members affected by NCDs. RESULTS:Participants across all groups articulated a shared complex understanding of both the structural and direct determinants behind NCD onset. Lebanese and Syrian community members further identified several barriers to health seeking, including restrictions in health coverage, limited availability of services in the Beqaa and perceptions of poor-quality care. Health providers and community members described a health system overtly focused on disease control and overwhelmed by delivery of care to people living with NCD across both communities. CONCLUSION:Participants across all groups agreed on the need for health promotion and primary prevention activities and identified priority interventions in these areas.
Entities:
Keywords:
Fragility; Non-communicable diseases; Prevention; System dynamics
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