Accessibility to healthcare services and treatment for people with noncommunicable diseases in northwest syria

Background: Non-communicable diseases (NCDs) are the leading cause of death and disability globally. After more than eleven years of the worst humanitarian crisis in Syria, the response to NCDs-related needs in Northwest Syria is still a challenge. The aim of this research is to assess the accessibility to healthcare services, and treatment, for people with NCDs in Northwest Syria. Methods: it is a cross sectional study. It was carried out among people with NCDs. People with one or more of cardiovascular diseases, diabetes, cancer, or chronic obstructive pulmonary diseases were included. People from Aleppo and Idleb governorates, from camps or outside the camps were included. Data were collected from Nov 1 to 30. 2022 through face-to-face interviews. Results and conclusion: The results were obtained from 674 respondents. The majority (80.9%) were from the age group above 45 years old, with a mean 55.6. Females were 52.8% of the participants. Among the study group, cardiovascular diseases were the most dominant NCD (68.2%), then diabetes (45.1%), COPD (11.6%), and cancer (1.8%), with (25.8%) of the respondents reported more than one NCD. Fixed public health facilities (60.5%), and pharmacies (18.5%) were the most common type of the accessible healthcare settings. Our findings indicated that respondents in Idleb were 6.5 times more likely to access healthcare services than Aleppo (p=0000). Though no statistical significance was found between in-camp and outside-camps residents for accessibility to healthcare services, in-camp residents were 1.5 times more likely to access outreach health services (p=0.020). Employed respondents were 2 times more likely to access healthcare services compared to unemployed respondents (p=0.015). Respondents whose income equal to or higher than the expenses were 3 times more likely to access healthcare services compared to respondents whose income less than expenses (p=0.000). Having any of the surveyed NCDs, made the respondents less likely to get the required services (and especially, free medication) with the greatest impact of cancer. Unavailability of the health services themselves (p=0.000), lack of information about the available services (p=0000), distance/ transportation cost to reach the health settings (p=0.015), service/ medications cost (p=0.000), security reasons (p=0.013), and other reasons including mistrust of the health providers, cultural reasons and barrier languages (p=0.000) were identified as barriers to accessing healthcare services.