Quality management of chronic illnesses among vulnerable older adults in a complex humanitarian setting: Outcomes and lessons learned – The case of Syrian refugees and host communities in Lebanon

Despite the emergence of non-communicable diseases (NCDs) in the Arab region, capacity for prevention and control remains inadequate in resource-scarce countries, and is accentuated in times of uncertainty and conflict. With the massive influx of Syrian refugees to Lebanon in the past three years, HelpAge International and the Center for Public Health Practice at the American University of Beirut are collaborating to evaluate a pilot intervention for quality management of NCDs with focus on hypertension and diabetes among adults aged over 40. The intervention, implemented in 5 healthcare centers of AMEL association – a community based NGO with a long history of service to disadvantaged populations in Lebanon, aims to improve the management of diabetes and hypertension among Syrian refugees and host communities at the primary health care (PHC) level. Using both quantitative and qualitative methods, the evaluation aims to answer several questions: In a setting like Lebanon where Syrian refugees are living in informal settlements, how can the impact of such interventions be measured? What are effective capacity building activities which enhance the quality of services provided in PHC centers catering for health needs of vulnerable older people? Are such interventions effective in disadvantaged contexts of high uncertainty where healthcare centers lack human and other resources? What are the barriers and facilitators to implementing this intervention in complex humanitarian settings? Findings and lessons learned from this evaluation will feed in the process of scaling up interventions for management of chronic illness among older people in similar humanitarian settings.