1. Participants are able to explain the importance of addressing the needs of people with Non-Communicable Diseases (NCD) in acute and protracted crises and the challenges to ensure their treatment and care

1.1. Participants are able to describe the types of diseases included in the NCD group

• Identifying NCD

• Classifying NCD

1.2. Participants are able to explain the key characteristics of NCD and what the differences are with Communicable Diseases (CD)

• Characteristics of NCD

  • Complex etiology and multiple risk factors

  • Mostly long /life time duration; generally slow progression with a continuum from the risk of a NCD to having a NCD to having a NCD with complications and death

  • Need for continuum of care over time and at different levels of care; requires coordination and follow-up/ integration across different levels of care – See Health care services

  • Coordination of care for NCD patients goes beyond health care services, e.g. nutrition

  • For certain NCD patients there is a need for palliative care

• Differences NCD and CD

1.3. Participants are able to describe overall NCD prevalence and mortality and how these are affected by crisis situations

• Burden of NCD worldwide (overall) and for specific regions

  • Prevalence; mortality trends

  • Epidemiological shift

  • Effects of crisis situations (examples)

1.4. Participants are able to explain ways in which a crisis might worsen the health of people with NCD

• Risk of complications during crisis situations

  • Influence of stress on NCD patients' health (e.g. insecurity; degradation of living conditions and nutrition; displacement)

  • Patients' loss of drugs, prescriptions, medical materials and/or devices

• Effects of crisis situations on treatment and care

  • Interruption of care for NCD patients due to stress on the health services (e.g. overload of existing services; destruction of infra-structure; loss of human resources and medical supplies)

  • Patients' inability to access available services & drugs /Utilization of existing health care services

2. Participants are able to identify an appropriate response to treatment and care needs of people with NCD during acute and protracted crisis

2.1. Participants are able to identify the burden of NCD in a specific crisis situation

• Need for detailed contextual info during a specific crisis to enable decision making

  • Crisis setting, crisis type

  • Main groups of NCD; disaggregation of data

  • Sources of information for prevalence & mortality data

2.2. Participants are able to assess the pre-crisis health care services for people with NCD and how a crisis may affect these services - See also module Health Care Services

• Types and levels of health care services

  • Continuum of care: Levels of care, over time

  • WHO Package of Essential Noncommunicable (PEN) disease interventions for Primary Health Care

• Core components (building blocks) for health care services /health facilities to ensure continuum of care

• Access of different population groups to /utilization of existing services (pre-crisis; since onset crisis; making the invisible visible)

2.3. Participants are able to describe criteria for the selection of patients with NCD who should be targeted as priority during a crisis situation

• Intervention priorities during an acute crisis

  • Strategic response plan: Most lifesaving, time critical, critical enabling

    • Patients with acute conditions that need immediate care and /or rapid referral

    • patients that can progress to rapid deterioration or complications if proper care is not provided in a timely manner

    • patients with stable conditions and without symptoms, who primarily need continuation of treatment)

• Interventions during protracted crisis: As for acute crisis plus extend care to patients with NCDs not covered in the acute phase and to prevention

• Consider all people affected by the crisis: Impartiality / equity

2.4. Participants are able to propose an appropriate response based on the available health care services capacity

• Gaps /Imbalance between needs and services (continuum of care)

• Access to available services - See session Health care services

• Type and level of intervention should correspond to the pre-crisis level in the context and be adapted to the type of crisis (Not recommended to introduce a higher level of care that is not sustainable) (Ref. to 2.2. above)

• Patient centeredness of management of the disease /patient empowerment

• Ethical dilemmas around patient inclusion /exclusion

  • Utilitarian principle: the best for the most

• Palliative care

• Yes / no carrying out active case finding (to be considered only for high risk patients in order to improve their management).

• Importance of confidentiality of personal data