Strengthening health quality management for cardiovascular disease, diabetes, and obesity in the United Arab Emirates: an integrated evidence synthesis

Introduction Non-communicable diseases (NCDs), particularly cardiovascular diseases (CVDs), diabetes, and obesity, represent a major public health challenge in the United Arab Emirates (UAE). Despite strong policy and governance frameworks to address NCDs, evidence on Health Quality Management (HQM) remains fragmented, limiting the development of actionable system-level insights. Integrating empirical evidence with interest groups' experience can provide a more comprehensive and contextual understanding of HQM practices and implementation challenges. This study aims to synthesize evidence from a scoping review and interest groups' perspectives to identify systemic gaps, challenges, and recommendations for strengthening HQM in CVD, diabetes, and obesity care in the UAE. Methods An integrated evidence synthesis was conducted using findings from a scoping review (phase 1) and interviews with 20 interest groups representing healthcare regulators and providers, academia, and patient groups (phase 2) from a multi-phase study on HQM practices in NCD care in the UAE. Data were analyzed using thematic synthesis guided by an integrated HQM framework. A mixed deductive-inductive coding and triangulation process were applied to identify areas of convergence, complementarity, and divergence between evidence sources to generate synthesized areas including gaps, challenges and recommendations. Results Eight interconnected synthesis areas were identified: governance and implementation; access, equity and financial protection; health workforce and care culture; digital systems and data generation; care coordination and service delivery; patient-centered care and engagement; community engagement and health literacy; and multisectoral collaboration for NCD prevention. Findings revealed strong policy commitment, regulatory frameworks, and expanding digital health capacities supporting NCD care. However, persistent gaps were identified in policy implementation, care coordination, workforce competencies, digital interoperability, outcome evaluations, financial protection, equitable access, and patient and community engagement. Siloed governance and service delivery information systems, high dependency on expatriate workforce, and inconsistent cross-sector collaboration limited the translation of structural strengths into effective and equitable service delivery. Conclusion The UAE possesses a strong policy and structural foundation for NCD quality management; however, substantial gaps remain in translating structural readiness into coordinated, patient-centered, and outcome-oriented care. Strengthening integrated governance, digital interoperability, workforce competencies, equity-focused policies, intersectoral collaboration, and performance measurement systems are essential to achieve sustainable improvements in NCD care quality and outcomes.