title: Prevalence of non-communicable diseases and access to health care and medications among Yazidis and other minority groups displaced by ISIS into the Kurdistan Region of Iraq.
abstract: BACKGROUND
  The increasing caseload of non-communicable diseases (NCDs) in displaced populations poses new challenges for humanitarian agencies and host country governments in the provision of health care, diagnostics and medications. This study aimed to characterise the prevalence of NCDs and better understand issues related to accessing care among Yazidis and other minority groups displaced by ISIS and currently residing in camps in the Kurdistan Region of Iraq.
  
  
  METHODS
  The study covered 13 camps managed by the Kurdish Board of Relief and Humanitarian Affairs. A systematic random sample of 1300 households with a total of 8360 members were interviewed between November and December 2015. Respondents were asked whether any household members had been previously diagnosed by a health provider with one or more of four common NCDs: hypertension, diabetes, cardiovascular disease and musculoskeletal conditions. For each household member with an NCD diagnosis, access to health care and medications were queried.
  
  
  RESULTS
  Nearly one-third of households had at least one member who had been previously diagnosed with one or more of the four NCDs included in this study. Hypertension had the highest prevalence (19.4%; CI: 17.0-22.0), followed by musculoskeletal conditions (13.5%; CI: 11.4-15.8), diabetes (9.7%; CI: 8.0-11.7) and cardiovascular disease (6.3%; CI: 4.8-8.1). Individual NCD prevalence and multimorbidity increased significantly with age. Of those with an NCD diagnosis, 92.9% (CI: 88.9-95.5) had seen a health provider for this condition in the 3 months preceding the survey. In the majority of cases, care was sought from private clinics or hospitals rather than from the camp primary health care clinics. Despite the frequent access to health providers, 40.0% (CI: 34.4-46.0) were not taking prescribed medications, costs being the primary reason cited.
  
  
  CONCLUSIONS
  New strategies are needed to strengthen health care provision for displaced persons with NCDs and ensure access to affordable medications.
authors.affiliation: Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA.|Middle East Centre, London School of Economics and Political Science, London, UK.
authors.forename: Valeria
authors.initials: V
authors.lastname: Cetorelli
authors.affiliation: Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Burnham
authors.affiliation: Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Kurdistan Region Iraq.
authors.forename: Nazar
authors.initials: N
authors.lastname: Shabila
keywords: Access to health care; Displacement; Iraq; Kurdistan Region; Non-communicable diseases; Yazidis