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Prevalence of non-communicable diseases and access to health care and medications among Yazidis and other minority groups displaced by ISIS into the Kurdistan Region of Iraq

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ABSTRACT

Background: 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 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.

Methods: The 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.

Results: Nearly 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.

Conclusion: New strategies are needed to strengthen health care provision for displaced persons with NCDs and ensure access to affordable medications.

No MeSH data available.


Odds ratios of taking medications as prescribed among those who had visited a hospital or private clinic compared to those who had visited the camp PHCC (with 95% CIs)
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Fig5: Odds ratios of taking medications as prescribed among those who had visited a hospital or private clinic compared to those who had visited the camp PHCC (with 95% CIs)

Mentions: Having seen a health provider for their NCD in the past 3 months was considerably more frequent than currently taking prescribed medications for their condition (Fig. 3). The cost of medications was by far the major reason given by those who were not taking medications as prescribed by the health provider (Fig. 4). The adherence to prescribed treatment was 68.5% (CI: 61.2–74.9) for those with hypertension, 67.2% (CI: 56.8–76.1) for those with diabetes, 59.1% (CI: 44.7–72.1) for those with cardiovascular disease, and 34.8% (CI: 26.7–44.0) for those with musculoskeletal conditions (p < 0.001). Adherence to prescribed medications was associated with type of health facility visited (p < 0.001). Those who had sought care in hospital were 3.2 (CI: 1.6–6.3) times more likely to take medications as prescribed than those who had sought care in the camp PHCC (Fig. 5). There was no significant difference in terms of access to medications between those who had visited a private clinic and those who had sought care in the camp PHCC (p = 0.401).Fig. 4


Prevalence of non-communicable diseases and access to health care and medications among Yazidis and other minority groups displaced by ISIS into the Kurdistan Region of Iraq
Odds ratios of taking medications as prescribed among those who had visited a hospital or private clinic compared to those who had visited the camp PHCC (with 95% CIs)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5382370&req=5

Fig5: Odds ratios of taking medications as prescribed among those who had visited a hospital or private clinic compared to those who had visited the camp PHCC (with 95% CIs)
Mentions: Having seen a health provider for their NCD in the past 3 months was considerably more frequent than currently taking prescribed medications for their condition (Fig. 3). The cost of medications was by far the major reason given by those who were not taking medications as prescribed by the health provider (Fig. 4). The adherence to prescribed treatment was 68.5% (CI: 61.2–74.9) for those with hypertension, 67.2% (CI: 56.8–76.1) for those with diabetes, 59.1% (CI: 44.7–72.1) for those with cardiovascular disease, and 34.8% (CI: 26.7–44.0) for those with musculoskeletal conditions (p < 0.001). Adherence to prescribed medications was associated with type of health facility visited (p < 0.001). Those who had sought care in hospital were 3.2 (CI: 1.6–6.3) times more likely to take medications as prescribed than those who had sought care in the camp PHCC (Fig. 5). There was no significant difference in terms of access to medications between those who had visited a private clinic and those who had sought care in the camp PHCC (p = 0.401).Fig. 4

View Article: PubMed Central - PubMed

ABSTRACT

Background: 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 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.

Methods: The 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.

Results: Nearly 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&ndash;22.0), followed by musculoskeletal conditions (13.5%; CI: 11.4&ndash;15.8), diabetes (9.7%; CI: 8.0&ndash;11.7) and cardiovascular disease (6.3%; CI: 4.8&ndash;8.1). Individual NCD prevalence and multimorbidity increased significantly with age. Of those with an NCD diagnosis, 92.9% (CI: 88.9&ndash;95.5) had seen a health provider for this condition in the 3&nbsp;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&ndash;46.0) were not taking prescribed medications, costs being the primary reason cited.

Conclusion: New strategies are needed to strengthen health care provision for displaced persons with NCDs and ensure access to affordable medications.

No MeSH data available.