Strengthening the primary care workforce to deliver high quality care for non-communicable diseases in refugee settings: lessons learnt from a UNHCR partnership

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Title: Strengthening the primary care workforce to deliver high quality care for non-communicable diseases in refugee settings: lessons learnt from a UNHCR partnership
Authors: Harris, P
Kirkland, R
Masanja, S
Le Feuvre, P
Montgomery, S
Ansbro, E
Woodman, M
Harris, M
Item Type: Journal Article
Abstract: Non-communicable disease (NCD) prevention and care in humanitarian contexts has been a long-neglected issue. Health care 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 health care 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 (PCI) 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 2,300 healthcare workers (HCW) have been reached through cascade trainings over the last six 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 healthcare workers (doctors, nurses, technical officers, pharmacy technicians and community health workers). Clinical guidance must be adapted to local settings whilst 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.
Issue Date: 7-Jul-2022
Date of Acceptance: 27-Jan-2022
URI: http://hdl.handle.net/10044/1/95069
DOI: 10.1136/bmjgh-2021-007334
ISSN: 2059-7908
Publisher: BMJ Publishing Group
Start Page: 1
End Page: 10
Journal / Book Title: BMJ Global Health
Volume: 7
Issue: Suppl 5
Copyright Statement: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Keywords: cardiovascular disease
diabetes
health systems
hypertension
COVID-19
Community Health Workers
Health Workforce
Humans
Noncommunicable Diseases
Primary Health Care
Refugees
United Nations
Humans
Refugees
United Nations
Primary Health Care
Community Health Workers
Noncommunicable Diseases
Health Workforce
COVID-19
Publication Status: Published
Online Publication Date: 2022-07-07
Appears in Collections:Faculty of Medicine
School of Public Health



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