Reducing non-communicable diseases among Palestinian populations in Gaza: a participatory comparative and cost-effectiveness modeling assessment
Sanjay Basu, John S. Yudkin, Mohammed Jawad, Hala Ghattas, Bassam Abu Hamad, Zeina Jamaluddine, Gloria Safadi, Marie Elizabeth Ragi, Raeda El Sayed Ahmad, Eszter P. Vamos, Christopher Millett
Purpose: Palestinians in Gaza have among the highest rates of non-communicable disease (NCD) in the world, yet ongoing conflicts have limited interventions to high-yield blood pressure, diabetes, and dyslipidemia treatments. We sought to assist in comparing the effectiveness and cost-effectiveness of potential new public health and healthcare NCD risk reduction efforts among Palestinians in Gaza.
Methods: We created and applied a microsimulation model using: (i) a cross-sectional household survey providing information about baseline characteristics and NCD risk factors among 4,576 Palestinian adults aged 40 years old and above in Gaza; (ii) a modified Delphi process for local public health experts to identify potentially feasible new interventions for NCD risk reduction in Gaza; and (iii) systematic reviews and meta-analyses of intervention effectiveness, with modifications for the Gazan and refugee contexts. The study was approved by the Institutional Review Boards of Al-Quds University and Imperial College London.