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Integration of Non-Communicable Disease Services within Primary Health Care

 
Introduction
The Primary Health Care Department at the Ministry of Public Health in collaboration with WHO, launched an initiative for the integration of Non-Communicable Diseases (NCD) program within Primary Health Care centers in Lebanon, in 2012. This initiative aimed at integrating a two-step early detection of Diabetes Mellitus and Hypertension as well as estimating the Total Cardiovascular Risk among beneficiaries aged 40 years and above. The model adopted in this initiative was based on the WHO’s 2012 package of Essential Non-Communicable Diseases interventions for Primary Health Care.
The two-step screening model consists of administering initially a screening tool by the health care workers whether in the setting of the health center or in the community. Step 1 consists of using this tool which is in the form of a questionnaire that tackles information related to the beneficiaries. The health care worker would then calculate the total cardiovascular risk for the beneficiary (using the WHO/International Society of Hypertension –WHO/ISH- risk prediction charts) and would refer him/her to the next step (Step 2) in case the total cardiovascular risk was greater than 10% or there was a previous history of diabetes or hypertension. Step 2 involves performing a set of laboratory tests and a referral to the treating physician for calculation of the final cardiovascular risk.
 
Development of the Non-Communicable Disease Program
The program has passed through many phases, in each phase many centers were trained on implementing and using the NCD programs tools and protocols. All the centers within the Primary Healthcare network were trained on NCD within the time period 2013 to 2017. Training sessions were done on regular basis including 25 centers per session. The training included the healthcare workers, nursing staff, administrative staff and physicians.
 
Continuous Support
In order to maintain the sustainability of the program, POINT OF CARE testing machines for NCD screening were distributed to all involved Primary Health Care centers.
Furthermore, to sustain the accuracy of the data entered daily by the centers, an NCD e module was developed by the IT MoPH department on the Health Information System to aid the centers to enter all the NCD related data and perform the calculations necessary for diagnosis of cardiovascular risks.
The MoPH encourages the Primary Health Care centers in Lebanon to organize outreach activities, events and campaigns to raise the awareness on health factors associated with cardiovascular diseases (CVDs), such as obesity, lack of physical activity and smoking (tobacco-use). MoPH provides educational material to support these activities.
 
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ATC Name B/G Ingredients Dosage Form Price
J01MA12 LEVOFLOX G Levofloxacin - 500mg 500mg Tablet, coated, scored 602,041 L.L
J01MA12 LEVOFLOXACIN- HAMELN G Levofloxacin - 500mg/100ml 5mg/ml Injectable solution 1,632,769 L.L
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J01MA12 LEVOFLOX-MEDIS 500 G Levofloxacin - 500mg/100ml 500mg/100ml Injectable solution 1,834,345 L.L
J01MA12 LOXAMOX G Levofloxacin - 500mg/100ml 500mg/100ml Injectable solution 747,176 L.L
J01MA12 LEVOFLOXACINA BASI G Levofloxacin - 5mg/ml 5mg/ml Injectable solution 56,572,950 L.L
S01CA01 LEVIOSA G Levofloxacin - 5mg/ml, Dexamethasone - 1mg/ml Drops solution 1,427,161 L.L
N01BB02 LIDOCAINE ARWAN G Lidocaine (HCl) - 0.5% 0.5% Injectable solution 1,995,158 L.L
N01BB02 LIDOCAINE ARWAN G Lidocaine (HCl) - 1% 1% Injectable solution 1,995,158 L.L
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D04AB01 LIDONOSTRUM BOMBA-SPRAY G Lidocaine - 10% 100mg/ml Spray, solution 747,176 L.L
N01BB02 LIDO-CARE G Lidocaine - 2% 2% Injectable solution 100,788 L.L
D04AB01 LIDONOSTRUM G Lidocaine - 50mg/g 50mg/g Ointment 1,069,699 L.L
N01BB02 LIDOCAINE HYDROCHLORIDE 1% G Lidocaine HCl - 1% 10mg/ml Injectable solution 5,912,907 L.L
N01BB02 LIDOCAINE- ORBUCELL G Lidocaine HCl - 1% 1% Injectable solution 1,787,950 L.L
N01BB02 LIDOCAINE AGUETTANT PRESERVATIVE FREE G Lidocaine HCl - 10mg/ml 10mg/ml Injectable solution 1,284,713 L.L
N01BB02 LIDOCAINE- ORBUCELL G Lidocaine HCl - 2% 2% Injectable solution 1,787,950 L.L
J01XX08 LINESPAN 600 G Linezolide - 600mg 600mg Tablet, film coated 3,308,540 L.L
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J01XX08 LINEZOLID ARROW G Linezolide - 600mg/300ml 2mg/ml Injectable solution 13,282,147 L.L
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R06AX13 LORATIN G Loratadine (micronised) - 10mg 10mg Tablet 247,267 L.L
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R06AX13 LORINE G Loratadine (micronised) - 5mg/5ml 5mg/5ml Syrup 215,015 L.L
R06AX13 LORADAD G Loratadine - 10mg 10mg Tablet 131,697 L.L
N05BA06 LORAZEPAM G Lorazepam - 1mg 1mg Tablet, scored 325,082 L.L
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L01ED05 LORBRENA B Lorlatinib - 100mg 100mg Tablet 403,677,371 L.L
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