Lessons learned from implementing the Non-Communicable Diseases Kit in a humanitarian emergency: an operational evaluation in Sudan.

Non-communicable diseases (NCDs) are a major global health concern, and their management is particularly challenging in humanitarian contexts where healthcare resources are limited. The WHO Non-Communicable Diseases Kit (WHO-NCDK) is a health system intervention targeted at the primary healthcare (PHC) level and designed to provide essential medicines and equipment for NCDs management in emergency settings, meeting the needs of 10 000 people for 3 months. This operational evaluation aimed to assess the effectiveness and utility of the WHO-NCDK in two PHC facilities in Sudan and identify key contextual factors that may influence its implementation and impact. Using a cross-sectional mixed-methods observational approach that combined quantitative and qualitative data, the evaluation found that the kit played a critical role in maintaining continuity of care when other supply chain solutions were disrupted. However, contextual factors such as local communities' unfamiliarity with healthcare facilities, the national integration of NCDs into PHC, and the existence of monitoring and evaluation systems were identified as important considerations for enhancing the WHO-NCDK's utility and usefulness. The evaluation suggests that the WHO-NCDK can be an effective intervention in emergency settings, provided that contextual factors such as local needs, facility capacity and healthcare worker capacity are considered before kit deployments.

Adaptation of care for non-communicable diseases during the COVID-19 pandemic: a global case study.

People living with non-communicable diseases (PLWNCDs) are at greater risk of severe COVID-19 illness. This case study highlights the adaptations that were made to humanitarian health programmes in five countries to reduce exposure risk for PLWNCDs during the COVID-19 pandemic. Common adaptations included facility-level administrative and engineering controls, improved triaging, change in prescribing practices, decrease in frequency of stable patient visits, shift to remote consultations and expanded scope of responsibility for existing community health workers. Despite fears of the impact on health service utilisation, PLWNCDs continued to seek services and changes in utilisation rates between the pre-COVID-19 and COVID-19 periods were attributed more to factors like population changes, COVID-19 travel restrictions, closure of other health services, and enhanced health education and community engagement. This study highlights the resilience and creativity of frontline health staff and managers, and their ability to make quick shifts in service delivery modalities in response to changes in risk for client groups in accordance with the evolving contextual reality. Other contextual changes such as infectious disease outbreaks, conflicts and natural disasters happen regularly within humanitarian settings, and specific groups are often more at risk. With more specific information about risks for different client groups, targeted approaches can be done to ensure that those most at risk of a specific threat are able to ensure access to sustained services.