Advancing Refugee Health Data Management: The Implementation of ICD-11 in UNRWA’s Primary Care System

Cassandra Broadwin (), Wafa’a Zeidan, Mai Siam, Nenad Kostanjsek, Henry Victor Doctor, Eman Abdelkreem Aly, Mohammad Shraim, Ghada Ballout and Akhiro Seita
Additional contact information
Cassandra Broadwin: United Nations Relief and Works Agency for Palestine Refugees, Amman 11814, Jordan
Wafa’a Zeidan: United Nations Relief and Works Agency for Palestine Refugees, Amman 11814, Jordan
Mai Siam: United Nations Relief and Works Agency for Palestine Refugees, Amman 11814, Jordan
Nenad Kostanjsek: World Health Organization, 1211 Geneva, Switzerland
Henry Victor Doctor: World Health Organization, Regional Office for the Eastern Mediterranean, Cairo 11371, Egypt
Eman Abdelkreem Aly: World Health Organization, Regional Office for the Eastern Mediterranean, Cairo 11371, Egypt
Mohammad Shraim: United Nations Relief and Works Agency for Palestine Refugees, Amman 11814, Jordan
Ghada Ballout: United Nations Relief and Works Agency for Palestine Refugees, Amman 11814, Jordan
Akhiro Seita: United Nations Relief and Works Agency for Palestine Refugees, Amman 11814, Jordan

IJERPH, 2024, vol. 21, issue 9, 1-9

Abstract: The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) was one of the earliest healthcare systems globally to implement the International Classification of Diseases, Eleventh Revision (ICD-11) across its 140 clinics serving 5.9 million Palestine refugees. This paper discusses the integration of ICD-11 into UNRWA’s cloud-based electronic medical record (EMR) system, identifying both the barriers and facilitators involved and analyzing trends in clinical documentation and healthcare utilization. The key challenges included data privacy provisions, integration into a coordinated care model, complex classification schema for primary care settings, frequent staff turnover, and limited data analysis capabilities. Conversely, facilitators included physician-tailored training and on-site support, system compatibility, a multidisciplinary team approach, policy support from UNRWA and the World Health Organization (WHO), and leadership commitment and effective change management. Medical officers (MOs) using ICD-11 reported greater satisfaction with the system’s capabilities in managing and visualizing health information. This article contributes to the discourse on health data management in complex humanitarian settings, offering insights into the benefits and challenges of implementing advanced classification systems like ICD-11. Future research should explore longitudinal impacts and further integration with global health systems, ensuring that the advancements in classification continue to support the overarching goal of health equity and access in vulnerable and hard-to-reach populations.

Keywords: ICD-11; Jordan; Syria; Lebanon; Gaza; West Bank; refugee health; complex humanitarian setting; implementation science; global health informatics; health equity; gender minority health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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