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Strengthening the primary care workforce to deliver high-quality care for non-communicable diseases in refugee settings

Lessons learnt from a UNHCR partnership

Bibliographic Data

ID21879883
AuthorsPhilippa Harris (0000-0002-9222-7864, International Foundation for Integrated Care, corresponding author), Ros Kirkland (International Foundation for Integrated Care), Saimon Masanja (Catholic University of Health and Allied Sciences), Peter Le Feuvre (International Foundation for Integrated Care), Sarah Montgomery (0000-0002-4189-5416, International Foundation for Integrated Care), Éimhín Ansbro (0000-0002-2291-1652, London School of Hygiene & Tropical Medicine), Marmaduke Woodman (0000-0002-8410-4581, Office of the United Nations High Commissioner for Refugees), Michael Woodman (The Office of the United Nations High Commissioner for Refugees, Geneva, Switzerland), Matthew Harris (0000-0002-8201-5817, Imperial College London)
Year2022
Volume7
IssueSuppl 5
Pagese007334
Publication date2022-07-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2021-007334
PMID35798443
OpenAlexW4284712482
LanguageEN
Citations received8
References cited22

Non-communicable disease (NCD) prevention and care in humanitarian contexts has been a long-neglected issue. Healthcare systems in humanitarian settings have focused heavily on communicable diseases and immediate life-saving health needs. NCDs are a significant cause of morbidity and mortality in refugee settings, however, in many situations NCD care is not well integrated into primary healthcare services. Increased risk of poorer outcomes from COVID-19 for people living with NCDs has heightened the urgency of responding to NCDs and shone a spotlight on their relative neglect in these settings. Partnering with the United Nations Refugee Agency (UNHCR) since 2014, Primary Care International has provided clinical guidance and Training of Trainer (ToT) courses on NCDs to 649 health professionals working in primary care in refugee settings in 13 countries. Approximately 2300 healthcare workers (HCW) have been reached through cascade trainings over the last 6 years. Our experience has shown that, despite fragile health services, high staff turnover and competing clinical priorities, it is possible to improve NCD knowledge, skills and practice. ToT programmes are a feasible and practical format to deliver NCD training to mixed groups of HCW (doctors, nurses, technical officers, pharmacy technicians and community health workers). Clinical guidance must be adapted to local settings while co-creating an enabling environment for health workers is essential to deliver accessible, high-quality continuity of care for NCDs. On-going support for non-clinical systems change is equally critical for sustained impact. A shared responsibility for cascade training—and commitment from local health partners—is necessary to raise NCD awareness, influence local and national policy and to meet the UNHCR’s objective of facilitating access to integrated prevention and control of NCDs

Communicable disease · General partnership · Health care · Political science · Public health · Refugee · Workforce · Global Maternal and Child Health · Global Public Health Policies and Epidemiology · Healthcare Systems and Reforms · Medicine · Nursing

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Unique citing works8
Citations per year2
Citation span2022 - 2026 (5)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 8

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