Evidence mapPaperPMID 41920892Full record

ArticlePLOS global public health2026

Integrating noncommunicable disease care in a public primary health care facility in North Lebanon: A qualitative study of implementation in a humanitarian crisis.

Linda Abou-Abbas, Lavanya Vijayasingham, Carla Zmeter, Aya El Khatib, Grace Abou Nakad, Leah Anku Sanga, Randa S Hamadeh, Pablo Perel, Sigiriya Aebischer Perone, Éimhín M Ansbro

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Article in PLOS global public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Linda Abou-AbbasInternational Committee of the Red Cross, Beirut, Lebanon.ORCID https://orcid.org/0000-0001-9185-3831
Lavanya VijayasinghamNCD in Humanitarian Settings Special Interest Group, Centre for Global Chronic Conditions and Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.ORCID https://orcid.org/0000-0002-4424-4491
Carla ZmeterInternational Committee of the Red Cross, Beirut, Lebanon.ORCID https://orcid.org/0000-0001-5185-6456
Aya El KhatibInternational Committee of the Red Cross, Beirut, Lebanon.
Grace Abou NakadInternational Committee of the Red Cross, Beirut, Lebanon.ORCID https://orcid.org/0009-0004-7741-0005
Leah Anku SangaNCD in Humanitarian Settings Special Interest Group, Centre for Global Chronic Conditions and Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.ORCID https://orcid.org/0000-0003-1604-0771
Randa S HamadehPrimary Healthcare and Social Health Department, Ministry of Public Health, Baabda, Lebanon.
Pablo PerelNCD in Humanitarian Settings Special Interest Group, Centre for Global Chronic Conditions and Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Sigiriya Aebischer PeroneInternational Committee of the Red Cross, Geneva, Switzerland.ORCID https://orcid.org/0000-0002-4702-8671
Éimhín M AnsbroNCD in Humanitarian Settings Special Interest Group, Centre for Global Chronic Conditions and Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.ORCID https://orcid.org/0000-0002-2291-1652

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Integrated care for non-communicable diseases (NCDs) may enhance care delivery, clinical impact, user-satisfaction, and access. However, evidence on integrated NCD care in humanitarian settings remains scarce. This qualitative study accompanied the first year of implementation (March 2023 to March 2024) of an integrated care programme at an International Committee of the Red Cross (ICRC)-supported, Ministry of Public Health-affiliated primary healthcare centre (PHC) in North Lebanon. A preceding theory of change (TOC) workshop on combining NCD PHC, mental health and psychosocial support (MPHSS), and rehabilitation services, identified two interdependent pathways to integrated NCD care: the multidisciplinary service pathway and the patient/family support pathway. The REAIM PRISM implementation science framework guided the study design, analysis and reporting. We interviewed service users and ICRC/PHC staff and analysed interview data alongside programme documentation using a joint thematic and constructive grounded theory approach. Overall, integrated care was feasible despite contextual challenges, including economic crisis, job losses, regional tensions, and insufficient NCD financing. A key overarching theme emerged: staff-related human values, motivation, and work ethic driving action amid personal and professional adversity. Implementation narratives described assimilating new processes, adapting to contextual challenges, and resolving process-oriented problems. In the first year, interventions under the TOC's multidisciplinary pathway-such as training, streamlined processes, and improved data systems-were prioritized, notably incorporating MHPSS and diabetic foot screening, while interventions in the patient empowerment pathway were not yet implemented. PHC NCD care remained the entry point for integrated care with unidirectional referrals to collocated services. Most service users reported no change in their clinic experience; however, many positively noted improvements in programme quality, respect, and trust. Limited awareness or demand for MHPSS services was observed. Strengthening bidirectional referrals, multidisciplinary meetings, patient and caregiver empowerment, and promotion of self-care may address unmet needs and promote uptake of MHPSS and rehabilitation services.

Identifiers

PMID41920892
PMCPMC13042628

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.