Exploring Health Needs and the Double Burden of Diseases in Adults Attending Public Health Facilities in the Iraqi Kurdistan

Stefania Moramarco^1*Mariagrazia Cicala¹Faiq B. Basa²Gorgees S. Akhshirsh³Antonia Bezenchek⁴Rafal S.L. Adhama²Bayar S. Azeez³Sivar A. Qadir⁵Shahla O. Salih⁶Luma H.H. Alhanabadi⁷Iuri Fanti⁸Berivan A. Tofiq⁹Daniele Di Giovanni¹Leonardo Emberti Gialloreti¹Paola Scarcella¹⁰

• ¹Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
• ²Rizgary Teaching Hospital, Erbil, Iraq
• ³Computer Systems Engineering, Erbil, Iraq
• ⁴INFORMAPRO SRL, Rome, Italy
• ⁵Directorate of Health, Sulaimaniya, Iraq
• ⁶Department of Statistics and Informatics, University of Sulaimaniya, Sulaimaniya, Iraq
• ⁷Primary Health Care Department, Preventive Health Affairs Directorate, Duhok, Iraq
• ⁸EuResist Network GEIE, Rome, Italy
• ⁹Directorate of Health, Halabja, Iraq
• ¹⁰Department of Human Sciences, LUMSA University, Rome, Italy

Objective: We analyzed the health needs of the adult population accessing public health facilities in the Iraqi Kurdistan, a region facing both demographic and epidemiological transitions while undergoing post-crisis recovery. We investigates the prevalence and distribution of communicable and noncommunicable diseases using real-world data from a digital surveillance system Methods: Data collected across public health centers (PHC) were extracted from the KRG DHIS2 digital health platform. All records from adult patients were coded using the WHO ICD-10. Diagnoses were grouped into: Communicable, maternal, neonatal and nutritional diseases (CMNNDs), Noncommunicable diseases (NCDs), Injuries, Ill-defined diseases. Statistical analyses included descriptive statistics, age-related trends and sex-specific comparisons. Results: A total of 1,040,695 health events were recorded (years 2016-2022) across 96 PHC: 899,173 were classified as either CMNNDs (41.1%) or NCDs (58.9%). Significant sex and age differences were observed across all major diagnostic categories. NCDs were more common in all age groups and increased significantly with age, while CMNNDs predominated among younger adults. Females accounted for 63.4% of all health events and exhibited higher rates of visits for endocrine, genitourinary, and hematologic conditions. Respiratory system diseases were the most common diagnoses across all ages, followed by genitourinary and digestive system diseases. Conclusion: This study provides critical evidence for understanding health service utilization and disease burden in Iraqi Kurdistan, using a real-time digital surveillance system. The findings confirm the presence of a double burden of disease in a population undergoing rapid transition and underscore the need for integrated, age-and sex-sensitive health interventions.