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4 Results for Health Topics

4.6 Non-communicable disease

4.6.2 Expert interviews

Key findings from the expert interviews were as follows:

  • There was some consensus that NCDs in humanitarian crises were not generally seen as a priority for intervention, nor for research. It was therefore felt that one of the priorities for NCDs should be to make their case as an important public health issue during humanitarian crises.
  • Another priority evidence gap that emerged was around protocols, guidelines and frameworks for NCDs that could be translated to different crisis scenarios. One specific gap cited was in the inclusion of NCDs in the basic package of health care for humanitarian crises.
  • There was a sense that knowledge already exists around what interventions are effective for NCDs but that there was a gap in knowledge around implementation. One expert thought that improvements had been made in effective delivery mechanisms, citing the case of Haiti. However, this review did not uncover any studies from Haiti.
  • Acute conditions, such as kidney injury or complications of NCDs were seen to take precedence. NCDs, in particular hypertension and diabetes, are increasing problems pre-crisis and it was thought that evidence should expand to cover these more diverse health needs.
  • Data collection was seen as a barrier to developing evidence in crisis settings. Assessments of health needs were reliant on verbal accounts of current needs. Conflict zones bore additional problems since it was difficult to continue data collection while working in dangerous conditions, which called the accuracy of data into question. Also, information on resource and infrastructure are often classified in these settings.
  • Ethical approval was cited as a common obstacle to research in crisis settings.
  • Experts proposed that a pre-conflict understanding of NCD needs would assist the understanding of the interventions needed in an emergency. Before and after study designs were recommended, in particular to understand how best to ensure continuity of care and reduction of complications.
  • There was considered to be a lack of follow up of NCD interventions. Longitudinal study designs were recommended.
  • There was felt to be a lack of consideration of older people during crises, who are disproportionately affected by NCDs. Age stratification of these older age groups was therefore recommended.
  • Several experts highlighted the problem of lack of essential drugs for NCDs in emergency kits.
  • Suggestions were made for the development of guidelines and standards centred on sharing learning from other chronic diseases such as HIV/AIDS and tuberculosis.
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