 Okay, so we're going to move on to Dr. Anne Burton, who is the Acting Chief of Public Health at the UNHCR. She has worked for UNHCR for 11 years, but now is in Geneva, where there's a small team that kind of overlooks HCR's technical health programs. So we're going to get your presentation on us. Thank you. Good afternoon, everybody, and thank you to the organizers for giving me the opportunity to present today. I'm going to go quickly through. We were asked to talk about our monitoring systems in relation to NCDs. So what I'm actually going to do is to look at the extent to which the existing tools that we have are suitable for monitoring NCD programs. I'll be starting with our health information system, and then moving on to also national data collection and reporting systems. Before we started to look at this, we started to think, well, what are we actually comparing it to? What data should we be collecting? There's no, as far as we're aware, and I guess that's one of the reasons that we're here. We've standardized or sort of agreed a set of data that we should be collecting on NCDs in humanitarian settings. So just for the purposes of the presentation, I decided to compare it with WHO's Global Monitoring Framework, which breaks the NCD surveillance down into three separate areas, mortality and morbidity risk factors, which are both behavioral and biological, and then health system responses. So firstly, the health information system that we have is primarily a surveillance tool, which is mainly to monitor communicable diseases, reproductive health, nutrition and mortality. It's in place in 143 sites in 26 countries, but it was developed for health services which are not yet well adapted to manage NCDs. It does collect data that's disaggregated by age and gender. It includes four age categories, including those that are of interest to NCDs, which is from the 18 to 59 and over 60. Just as an example, this shows the proportion of NCD consultations in UNHCR supported primary health care centers from a number of countries in 2015. It's not including data from the Middle East, which I will show shortly, but the countries where the proportion of total consultations that were NCDs was above 10% are the long-term stable settings, such as Namibia, Nepal, and Bangladesh, and Ghana. For example, in Kenya, this is Dada refugee camp, and this was out of over nearly 1 million consultations annually. In 2013, only 30,000 of these, or 3%, were non-communicable diseases. This is not including, for example, mental health, which is collected separately, and it's not including injuries or nutrition, which are also collected separately. This is in contrast to Jordan. This is the data from 2015 from Zatri Camp, where out of nearly half a million consultations, 17% of these were non-communicable diseases. So again, not including mental health or injuries. It shows the commonest types of non-communicable diseases, which we won't go into because it's been shown, but mainly hypertension and diabetes, and you can see the age categories as well. We do also collect mortality, and one of the indicators in the global monitoring framework is actually the risk of dying prematurely, which is between the ages of 30 and 70, of one of the four main NCDs. Now, we obviously can't collect this data from the HIST, but we can calculate, for example, in Zatri in 2015, that 35% of the total deaths were what we would call prematurely, premature deaths due to NCDs, that were due to these four main NCDs. So the HIST is one tool, and it's particularly useful for the first two objectives, but for the last three, we need other tools. So we have another tool which we use to monitor the quality of care and the performances of health services, which measures or which assesses these in five key areas, including the services, the staffing and coverage, equipment and supplies, quality of care, as well as health worker and patient satisfaction. This data is entered into tablets. It takes about two days to do one health facility, and it measures indicators at the facility level. And depending on what the score is, it can be conducted if the score is low, then it's conducted again after recommendations within a three-month period. If the score is reasonably high, then it would be conducted after a year. But when we started doing this in the Middle East, we found that it really wasn't well adapted to settings where the NCD burden was much higher. So currently we have a consultant who's developing, who's making some changes to the scorecard, and one of the areas that he or she is looking at is improving the monitoring of those five areas in relation to NCDs. The third tool that we have is what we call a Health Access and Utilization Survey, which is, again, is a survey that we started to do in the Syrian crisis. And it's actually, it's a telephone survey. It's very, very cost-effective. We were able to collect population-based data. There are a number of limitations as it's collected by telephone, and it's obviously just registered refugees and those which have a phone. But we can, for example, monitor quality of care, given that it is very, very cost-effective. It costs less than $10,000 to do one of these. And we were able to show that after the withdrawal of free health services in Jordan that those with NCDs who needed to access health care in the previous month, that those who couldn't access it, the prevalence, the proportion went up from 23%, the previous year, to 58%. The fourth tool that we have is what we call the SENS, which is a Standardized Expanded Nutrition Survey. And just wanted to mention that this is, of course, mainly based on acute malnutrition, but we also collect anemia prevalence. And we only are collecting anthropometric data in children 6 to 59 months and women of reproductive age, where we just do MIWAC. We've only done, looked at overweight and obesity in one setting. And currently we don't have indicators as to when we would look at this, but it's probably something that we should start. Electronic medical records, I think we've talked about with the cohort analysis that was presented by UNWA, but it's certainly something that we are looking at as well. And we do have a couple of partners who are implementing this. And we can certainly see the value in monitoring patient care and possibly improving surveillance as well. The last one that I wanted to talk about was just integration into a national system. So if we look at the global framework, again there was, for example, the biological and behavioral risk factors. It's not likely that we're going to have the resources in a refugee setting to be collecting this type of data. But for example, in Jordan in 2017, they are going to be doing a step survey. And we believe that refugees as a separate sample will be included in that survey. We also would advocate that national data collection systems such as cancer registry should also collect data, be disaggregated at least by nationality and preferably refugee status and similarly with vital registration systems. So in conclusion, there's no agreed set of NCD related indicators to monitoring humanitarian situations. Electronic medical records, they do provide opportunities to improve clinical management, data collection and also clinical audits. But they are costly and they often require information technology expertise that are currently not available in many settings and just the importance of national information systems. Thank you. Thank you, Anne. So we're a little bit behind about eight to ten minutes behind. Any clarification questions for Anne before we move on to the last presentation? Sorry, I may have scared people away. Okay, well, we'll return to this then.