Access to care for non-communicable diseases in Mosul, Iraq between 2014 and 2017: a rapid qualitative study

Abstract

During June 2014 to April 2017, the population of Mosul, Iraq lived in a state of increasing isolation from the rest of Iraq due to the city’s occupation by the Islamic State group. As part of a study to develop a generalisable method for estimating the excess burden of non-communicable diseases (NCDs) in conflict-affected settings, in April–May 2017 we conducted a brief qualitative study of self-reported care for NCDs among 15 adult patients who had fled Mosul and presented to Médecins Sans Frontières clinics in the Kurdistan region with hypertension and/or diabetes. Participants reported consistent barriers to NCD care during the so-called Islamic State period, including drug shortages, insecurity and inability to afford privately sold medication. Coping strategies included drug rationing. By 2016, all patients had completely or partially lost access to care. Though limited, this study suggests a profound effect of the conflict on NCD burden.Electronic supplementary materialThe online version of this article (10.1186/s13031-018-0183-8) contains supplementary material, which is available to authorized users.

An assessment of the quality of care provided at primary health care centres in camps for internally displaced persons in Iraq in 2018

“…It could imply that the experience of the patient in terms of quality in the facility and the feeling of being properly taken care of by the provider are crucial in providing quality of care. The literature in this regard, seemed to mostly corroborate this finding [27,[50][51][52], however, it cannot be fully answered here.…”

“…Beyond the quality of care, the focus has more often been on the quality of life in camps, either for refugees or IDPs, which includes aspects of health care services [22][23][24][25]. Most studies in IDP camps measure quality as set by SPHERE standards, others focus on the outcomes of specialised care [26][27][28][29]. Only a few studies attempt to consistently evaluate the quality of health care provision using SPHERE standards.…”

“…Additionally, the specific context may have led IDP not to be critical of the services received, skewing the results. In fact, the war in Iraq in 2003 and its long-term consequences severely weakened the health system [27,[50][51][52][53][54][55][56]. More broadly, a current debate in emergency setting camps is that people inside camps have access to better services than people outside camps [3,11,25,56,57].…”

Assessing the Accessibility of Home-Based Healthcare Services for the Elderly: A Case from Shaanxi Province, China

“…Israel explored financial accessibility of healthcare based on four factors of availability, geographic accessibility, affordability, and acceptability [ 23 ]. Baxter conducted a brief qualitative study of accessibility to healthcare services for non-communicable diseases from the three aspects of availability, affordability, and acceptability in Mosul, Iraq [ 24 ]. In addition to academic exploration, in January 2019, the government of Chaoyang District in Beijing launched the first document called “The Evaluation Standard of Home Renovation to Fit”, which aims to evaluate the accessibility of healthcare services for the elderly in terms of daily life ability, mental state, perception and communication, and social participation.…”

Methodological and Practical Considerations in Rapid Qualitative Research: Lessons Learned From a Team-Based Global Study During COVID-19 Pandemic

“…Rapid qualitative research (RQR) studies are increasingly valued as part of public health emergency response efforts (Baxter et al, 2018; Démolis et al, 2018; Johnson & Vindrola-Padros, 2017). RQR involves the adaptation of traditional social science research methods and are essentially defined by their duration, as the name suggests (Johnson & Vindrola-Padros, 2017; Vindrola-Padros & Johnson, 2020).…”