Healthcare system responses to non-communicable diseases’ needs of Syrian refugees: The cases of Jordan and Lebanon
Introduction: Since the start of the Syrian conflict in 2011, Jordan and Lebanon have hosted large refugee populations, with a high pre-conflict burden of non-communicable diseases (NCDs). We aimed to explore NCD service provision to Syrian refugees in these two host countries and to identify lesson...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | Journal of Migration and Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666623522000599 |
| _version_ | 1811294113679540224 |
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| author | Chaza Akik Farah Asfahani Tatiana Elghossain Sandra Mesmar Miriam Rabkin Wafaa El Sadr Fouad M. Fouad Hala Ghattas |
| author_facet | Chaza Akik Farah Asfahani Tatiana Elghossain Sandra Mesmar Miriam Rabkin Wafaa El Sadr Fouad M. Fouad Hala Ghattas |
| author_sort | Chaza Akik |
| collection | DOAJ |
| description | Introduction: Since the start of the Syrian conflict in 2011, Jordan and Lebanon have hosted large refugee populations, with a high pre-conflict burden of non-communicable diseases (NCDs). We aimed to explore NCD service provision to Syrian refugees in these two host countries and to identify lessons learned that may inform the global response to the changing health needs of refugees. Methods: Between January 2017 and June 2018, we conducted 36 in-depth interviews with stakeholders from Jordan and Lebanon, as well as global stakeholders, to understand the context, the achievements, gaps and priorities in the provision and uptake of NCD prevention, testing and treatment services to Syrian refugees. Findings: Both countries succeeded in embedding refugee health care within national health systems, yet coverage and quality of NCD health services offered to Syrian refugees in both contexts were affected by under-funding and consequent policy constraints. Changes in policies relating to cost sharing, eligibility and vulnerability criteria led to difficulties navigating the system and increased out-of-pocket payments for Syrians. Funding shortages were reported as a key barrier to NCD screening, diagnosis and management, including at the primary care level and referral from primary to secondary healthcare, particularly in Lebanon. These barriers were compounded by suboptimal implementation of NCD guidelines and high workloads for healthcare providers resulting from the large numbers of refugees. Conclusions: Despite the extraordinary efforts made by host countries, provision and continuity of high quality NCD services at scale remains a tremendous challenge given ongoing funding shortfalls and lack of prioritization of NCD care for refugees. The development of innovative, effective and sustainable solutions is necessary to counter the threat of NCDs. |
| first_indexed | 2024-04-13T05:11:47Z |
| format | Article |
| id | doaj.art-38379e3d3dec4bb6af75208bc9accb30 |
| institution | Directory Open Access Journal |
| issn | 2666-6235 |
| language | English |
| last_indexed | 2024-04-13T05:11:47Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Migration and Health |
| spelling | doaj.art-38379e3d3dec4bb6af75208bc9accb302022-12-22T03:01:00ZengElsevierJournal of Migration and Health2666-62352022-01-016100136Healthcare system responses to non-communicable diseases’ needs of Syrian refugees: The cases of Jordan and LebanonChaza Akik0Farah Asfahani1Tatiana Elghossain2Sandra Mesmar3Miriam Rabkin4Wafaa El Sadr5Fouad M. Fouad6Hala Ghattas7Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, LebanonCenter for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, LebanonCenter for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, LebanonCenter for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, LebanonICAP, Columbia University Mailman School of Public Health, New York, United StatesICAP, Columbia University Mailman School of Public Health, New York, United StatesDepartment of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, LebanonCenter for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Lebanon; Corresponding author.Introduction: Since the start of the Syrian conflict in 2011, Jordan and Lebanon have hosted large refugee populations, with a high pre-conflict burden of non-communicable diseases (NCDs). We aimed to explore NCD service provision to Syrian refugees in these two host countries and to identify lessons learned that may inform the global response to the changing health needs of refugees. Methods: Between January 2017 and June 2018, we conducted 36 in-depth interviews with stakeholders from Jordan and Lebanon, as well as global stakeholders, to understand the context, the achievements, gaps and priorities in the provision and uptake of NCD prevention, testing and treatment services to Syrian refugees. Findings: Both countries succeeded in embedding refugee health care within national health systems, yet coverage and quality of NCD health services offered to Syrian refugees in both contexts were affected by under-funding and consequent policy constraints. Changes in policies relating to cost sharing, eligibility and vulnerability criteria led to difficulties navigating the system and increased out-of-pocket payments for Syrians. Funding shortages were reported as a key barrier to NCD screening, diagnosis and management, including at the primary care level and referral from primary to secondary healthcare, particularly in Lebanon. These barriers were compounded by suboptimal implementation of NCD guidelines and high workloads for healthcare providers resulting from the large numbers of refugees. Conclusions: Despite the extraordinary efforts made by host countries, provision and continuity of high quality NCD services at scale remains a tremendous challenge given ongoing funding shortfalls and lack of prioritization of NCD care for refugees. The development of innovative, effective and sustainable solutions is necessary to counter the threat of NCDs.http://www.sciencedirect.com/science/article/pii/S2666623522000599SyriaNon-communicable diseasesHumanitarian crisesHealth systems |
| spellingShingle | Chaza Akik Farah Asfahani Tatiana Elghossain Sandra Mesmar Miriam Rabkin Wafaa El Sadr Fouad M. Fouad Hala Ghattas Healthcare system responses to non-communicable diseases’ needs of Syrian refugees: The cases of Jordan and Lebanon Journal of Migration and Health Syria Non-communicable diseases Humanitarian crises Health systems |
| title | Healthcare system responses to non-communicable diseases’ needs of Syrian refugees: The cases of Jordan and Lebanon |
| title_full | Healthcare system responses to non-communicable diseases’ needs of Syrian refugees: The cases of Jordan and Lebanon |
| title_fullStr | Healthcare system responses to non-communicable diseases’ needs of Syrian refugees: The cases of Jordan and Lebanon |
| title_full_unstemmed | Healthcare system responses to non-communicable diseases’ needs of Syrian refugees: The cases of Jordan and Lebanon |
| title_short | Healthcare system responses to non-communicable diseases’ needs of Syrian refugees: The cases of Jordan and Lebanon |
| title_sort | healthcare system responses to non communicable diseases needs of syrian refugees the cases of jordan and lebanon |
| topic | Syria Non-communicable diseases Humanitarian crises Health systems |
| url | http://www.sciencedirect.com/science/article/pii/S2666623522000599 |
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