Dynamics of non-communicable disease prevention, diagnosis and control in Lebanon, a fragile setting

From Springer Nature via Jisc Publications RouterKarin Diaconu - ORCID: 0000-0002-5810-9725 https://orcid.org/0000-0002-5810-9725Abstract: 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.This research was funded by the National Institute for Health Research (NIHR) Global Health Research programme 16/136/100.The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR or the Department of Health and Social Care.15pubpu