Outcomes and lessons from the integrated NCD-humanitarian response in Jordan (2020-2025)

约旦非传染性疾病与人道主义综合应对措施的成果和经验教训(2020-2025 年)

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Abstract

BACKGROUND: Jordan faces rising noncommunicable diseases (NCDs) amid protracted displacement. The 2020–2025 Integrated NCD–Humanitarian Response embedded NCD prevention and care across primary healthcare (PHC), humanitarian clinics, schools, and communities serving Jordanians and Syrian refugees. METHODS: An implementation-research case study synthesized routine service and biometric data, pre/post knowledge–attitude–practice (KAP) surveys, interviews/focus groups with providers, community health workers (CHWs), teachers, youth, and beneficiaries, and site observations. Outcomes included acceptability, appropriateness, adoption, feasibility, fidelity, penetration, effectiveness, and sustainability. Interventions adapted the Healthy Community Clinic (HCC) model, Healthy Schools Program, and youth/community outreach through provider training, standardized counseling tools, culturally adapted materials, and supportive supervision. Reach: >200 PHC centers plus NGO clinics, 319 schools, 119 CHWs, 48 community health committees, and 775 youth volunteers. RESULTS: Interventions were highly acceptable and appropriate, with strong adoption across PHC and humanitarian clinics and good school/community penetration. In Ministry of Health facilities, mean systolic/diastolic blood pressure fell by 10.5/5.0 mmHg and fasting glucose by 39.6 mg/dL (all p < 0.001); body mass index decreased by 0.6 Kg/m². In Al-Zaatari clinics, systolic blood pressure declined by 4.1 mmHg overall, with larger reductions among hypertensive patients; fasting glucose trended downward. KAP improved (> 40-point knowledge gains), physical inactivity dropped from 58.8% to 7.7% after three sessions, and vegetable intake roughly doubled. HCC roles, procedures, and indicators were incorporated into routine PHC operations and information systems, sustaining delivery beyond project facilitation. CONCLUSIONS: A context-tailored, multisector approach coupling PHC counseling with school and community action is feasible, effective, and increasingly institutionalized in humanitarian, resource-constrained settings. The model is scalable for strengthening NCD services for vulnerable populations in Jordan and similar contexts. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13690-025-01814-x.

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