 Thank you, and good morning, everyone. So since the beginning of the conflict in Syria, UNHCR has registered more than 600,000 Syrian refugees in Jordan, and actually the majority of them, they live within the Jordanian community, so not in refugee camps. Among others, the key healthcare needs are non-communicable diseases such as diabetes and hypertension, and therefore MSF treats already more than 3,500 refugees in Northern Jordan. The access to healthcare, actually access to healthcare was free of charge for those non-camp refugees until November 2014, since when the refugees actually have to pay for health services and public facilities, although at a subsidised rate. And previous surveys conducted in Jordan suggest that there's actually limited access to healthcare, including for NCD care. So therefore, we have conducted a study to determine the access to health services for non-camp Syrian refugees, and we looked at general adult health, child health, NCDs, and anti-natal care. I'm just showing you today the results from the NCD section. So specifically, we've looked at the healthcare needs, service utilization and expenditures, and then certainly we identified the main barriers to access to healthcare. So we conducted a cross-sectional household survey. We had 329 randomly selected clusters, and for each cluster we had eight households. As I said, so non-camp Syrian refugees, an ear-bit governorate, which is, by the way, here in Northern Jordan bordering Syria. We've included households arriving well after the conflict, and then for the NCD section, we looked only at adults. And the conditions we looked at, they were self-reported conditions. We looked at hypertension, diabetes type one and two, cardiovascular conditions, thyroid disease, chronic respiratory conditions, and lastly cancer. So we selected the clusters and their respective starting points via random GPS coordinate selection. We used mobile data collection tools based on the ODK, and we had 18 data collectors teams who conducted the survey between May and June 2016. Overall, we had 2,589 households consenting to participate in the survey, which overall covered almost 18,000 individuals, which was back then 12.4% of the population. So some results. So first of all, the adults were in the minorities of 45.7% were actually over 18 years old, and among those females represent the majority. And we see actually the biggest difference between male and female in the youngest age group between 18 and 39 years old, and then the gap actually declines with increasing age. We had quite a large proportion of 12.6% of the adults reporting they received no formal education. However, we had more than 60% who said they had received at least secondary education. An average household had about 6.8 members, and those 6.8 members lived on an average income of US$337 that was in the month prior to the survey. When we asked for the expenditures, they were substantially larger, so US$506. So unsurprisingly, with almost 80% of the households reported, they have accumulated a debt already. So then let's look at the prevalences. So the most prevalent condition was hypertension. That was reported by 14% of the adults followed by diabetes, and this is combined, type 1, type 2, 9.2%, and then thirdly, cardiovascular conditions at 5.7%. Then number four and five were chronic respiratory diseases and thyroid diseases, both of them less than 5%, and then lastly, cancer reported by 0.6% of the adults. So we also looked at actually the morbidities and comorbidities. So we had almost 45% of those with an NCD said they actually suffered from more than one condition, and the biggest groups here were hypertension only, and then we had 17.6% of patients said they suffer from hypertension and diabetes, and then diabetes only. So those two most prevalent conditions here make already 50% of the case load. And we have respiratory diseases, and then as the next big group is essentially the cardiovascular conditions to be added to this. So 8.1% of the patients said they had cardiovascular conditions in combination with hypertension diabetes, and then hypertension and cardiovascular conditions only, and lastly, only cardiovascular conditions. Now this is actually important, so knowing now the comorbidities, we can estimate that 21.8% of the adults suffer from at least one non-communicable disease. So next we investigated the access to care, and therefore we randomly selected one NCD patient per household, and looked at how often they've actually seen a medical doctor in the last six months. So it turns out that three-quarters of the patient had at least one consultation, and then when we asked for the last time the patient needed care, we had almost 23% said they did not seek NCD care the last time it was needed. So now very interestingly, the next question is what is the reason for it? And the main reason was affordability. So patients reported the provider costs were unaffordable, and that only includes direct healthcare costs. We have knowledge, for example, of not knowing where to go, or availability of services. So that also includes, for example, long waiting list. There were less prominent reasons, followed by approachability and acceptability. So in the approachability, we have transport issues and transport costs, and acceptability is, for example, rude or rejecting stuff behavior at the facilities. Now importantly, this is perceived affordability, and in order to essentially see whether economic household factors are somehow associated with the health-seeking behavior, we conducted a logistic regression analysis and looked at factors in general associated with seeking care when needed. And I'm only showing you the most interesting results here. So first of all, we found that age was an important determinant, as we found that almost... So, Mark, patients who are older than 60 years old are almost two times more likely to see care when needed compared to the younger stage group. Another important point was the type of the NCDs. So here we see that patients with a cardiovascular conditions were actually less likely to see care when needed compared to NCD patients who have any other conditions but cardiovascular conditions. In contrast to this, diabetic patients were more likely to see care, same's true for hypertension. So patients with hypertension were also more likely to see care when needed. So we're coming back to the economic factors. So the household income we looked at, and then in line with what was reported previously as a perceived affordability, we see here that patients coming from the richest household income quintiles were two times more likely to see care compared to patients from the lowest income quintile. Well, there was actually little evidence for an association for the other variables we looked at. So when we talk about affordability of services, the question is then certainly, so where did the patients actually go and how much did they pay for it? So the patients who did see care, mostly or the majority, slight majority of them went to an NGO sector, less than a third went to the public sector and 18% went to the private sector. And across all sectors, including those patients who did not pay for the services, the average cost for a complete medical visit, so including laboratory and medications, is on average 23 US dollars. And even though that doesn't sound a lot, at the end it's making up for almost 7% of the average household income that time. We also looked at access to NCD medication. So more than 90% of the NCD patients said they need regular medications for their NCDs, but 23.1% also said they had an interruption of their medication for the supply that lasted for longer than two weeks in the previous six months. Again, we asked for the reason and as previously noted again, it was reported it's an affordability issue. Other reasons that were mentioned is patients decided themselves to stop the medications or they did not know where to get the medications acted on MD instructions or a variety of other reasons. So before I come to the conclusions, a couple of limitations you might have noticed, so we'll talk here about self-reported NCDs that harvest the potential for under and over reporting. We're talking here also about a community that has prolonged limited access to care. So we can expect an under diagnosis of NCDs so the real prevalence could be in theory higher. We've used snowball sampling, which leads to clustering. We've been taking care of this in the design and the analysis. And then lastly, I've been mentioning several times economic factors and we've only looked so far at the household income. However, we have to actually look at the ability to pay. So after a cost for rent and everything is subtracted from the income. So there's an additional analysis to be done. Summary and conclusions. So in terms of needs, yes, NCD care is a key requirement. One in five adults suffer from at least one NCD. Case load comes from diabetes and hypertension. The access to NCD care, so yeah, the majority of patients we interviewed did access care, but still approximately a quarter of patients said they did not seek the care they needed and or they suffered from an interruption of medication. Barriers to care, the financial aspects of the reported affordability of the provider cost. High income patients were indeed more likely to seek care and then the financial burden of one NCD medical care visit is relatively high with 7%. If we talk about a disease which requires regular follow-up visits with the medical doctor. And then one aspect that we haven't looked at but even for those who did access medical care who were able to afford it, what are the opportunity costs for them? So what else could they not pay for after they've paid for the medical visit? So there's some more work to be done. And then overall we still see the need for increased support of NCD health services for Syrian refugees in Jordan and we hope to be able to engage national, regional and also international partners to help make this happen. So and then last but not least, that was certainly not all my work. Over the time we kept more than 100 people busy with that and I would sincerely thank everyone who's been working so hard on that. Thank you.