Experiences of communities with Lebanon's model of care for non-communicable diseases: a cross-sectional household survey from Greater Beirut

Objectives Assess community perceptions of the Lebanese care model for non-communicable diseases (NCDs) and trust in the health system among others, and test association between them. Design Cross-sectional study using multistage random sampling and targeting adult community members living with NCDs. Setting Households in Greater Beirut-Lebanon. Participants 941 respondents including 574 Lebanese community members and 367 Syrian refugees. Primary and secondary outcomes Three main outcomes (barriers to care seeking, perceptions of the care model and trust in healthcare) were assessed including by multiple linear regressions. Results Reported NCDs were hypertension (51.3%) and diabetes (34.5%), followed by chronic respiratory conditions (21.9%) and other cardiovascular diseases (20.0%). Communities reported seeking care from different sources. While 78% of Lebanese participants had visited private clinics at least once within the 6 months preceding the survey, 56% of Syrian refugees had done so. Determinants of access to care were health coverage, gender, and employment among Lebanese, and socioeconomic status among Syrian refugees. Lebanese community members had more positive perceptions of the care model compared with Syrian refugees and determinants included sociodemographic characteristics and the type of providers. Trust in the health system was higher among Syrian compared with Lebanese participants and was significantly influenced by the care model score and barriers to care seeking. Conclusion Our study generated evidence about the experience of people living with NCDs with Lebanon's care model and can inform service delivery interventions towards a more inclusive person-centred approach.