Skip to main content
Top
Published in: International Journal for Equity in Health 1/2016

Open Access 01-12-2016 | Research

Health service access and utilization among Syrian refugees in Jordan

Authors: Shannon Doocy, Emily Lyles, Laila Akhu-Zaheya, Ann Burton, Gilbert Burnham

Published in: International Journal for Equity in Health | Issue 1/2016

Login to get access

Abstract

Background

The influx of Syrian refugees into Jordan presents an immense burden to the Jordanian health system. Changing lifestyles and aging populations are shifting the global disease burden towards increased non-infectious diseases including chronic conditions, co-morbidities, and injuries which are more complicated and costly to manage. The strain placed on health systems threatens the ability to ensure the health needs of both refugees and host country populations are adequately addressed. In light of the increasing challenges facing host governments and humanitarian actors to meet health needs of Syrian refugees and affected host communities, this study was undertaken to assess utilization of health services among Syrian refugees in non-camp settings.

Methods

A survey of Syrian refugees in Jordan was undertaken in June 2014 to characterize health seeking behaviors and issues related to accessing care. A cluster design with probability proportional to size sampling was used to attain a nationally representative sample of 1550 non-camp Syrian refugee households. Differences in household characteristics by geographic region, facility type, and sector utilized were examined using chi-square and t-test methods.

Results

Care-seeking was high with 86.1 % of households reporting an adult sought medical care the last time it was needed. Approximately half (51.5 %) of services were sought from public sector facilities, 38.7 % in private facilities, and 9.8 % in charity/NGO facilities. Among adult care seekers, 87.4 % were prescribed medication during the most recent visit, 89.8 % of which obtained the medication. Overall, 51.8 % of households reported out-of-pocket expenditures for the consultation or medications at the most recent visit (mean US$39.9, median US$4.2).

Conclusions

Despite high levels of care-seeking, cost was an important barrier to health service access for Syrian refugees in Jordan. The cessation of free access to health care since the time of the survey is likely to have worsened health equity for refugees. Dependence of refugees on the public facilities for primary and specialist care has placed a great burden on the Jordanian health system. To improve accessibility and affordability of health services in an equitable manner for both refugees and Jordanian host communities, strategies that should be considered going forward include shifting resources for non-communicable diseases and other traditional hospital services to the primary level and creating strong health promotion programs emphasizing prevention and self-care are strategies.
Literature
1.
go back to reference International Federation of Red Cross and Red Crescent Societies (IFRC). Focus on Forced Migration and Displacement, World Disasters Report 2012. Geneva: International Federation of Red Cross and Red Crescent Societies; 2012. International Federation of Red Cross and Red Crescent Societies (IFRC). Focus on Forced Migration and Displacement, World Disasters Report 2012. Geneva: International Federation of Red Cross and Red Crescent Societies; 2012.
2.
go back to reference Spiegel, P, Public Health and HIV Section at UNHCR. Urban refugee health: meeting the challenges. Forced Migr Rev. 2010;34:22–23. Spiegel, P, Public Health and HIV Section at UNHCR. Urban refugee health: meeting the challenges. Forced Migr Rev. 2010;34:22–23.
4.
go back to reference Gutierres A, Spiegel P. The state of the world’s refugees: adapting health responses to urban environments. JAMA. 2012;308(7):673–4.CrossRef Gutierres A, Spiegel P. The state of the world’s refugees: adapting health responses to urban environments. JAMA. 2012;308(7):673–4.CrossRef
5.
go back to reference El-Khatib Z, Scales D, Vearey J, Forsberg BC. Syrian refugees, between rocky crisis in Syria and hard inaccessibility to healthcare services in Lebanon and Jordan. Confl Health. 2013;7:18.CrossRefPubMedPubMedCentral El-Khatib Z, Scales D, Vearey J, Forsberg BC. Syrian refugees, between rocky crisis in Syria and hard inaccessibility to healthcare services in Lebanon and Jordan. Confl Health. 2013;7:18.CrossRefPubMedPubMedCentral
6.
go back to reference Spiegel PB, Checchi F, Colombo S, Paik E. Health-care needs of people affected by conflict: future trends and changing frameworks. Lancet. 2010;375:341–5.CrossRefPubMed Spiegel PB, Checchi F, Colombo S, Paik E. Health-care needs of people affected by conflict: future trends and changing frameworks. Lancet. 2010;375:341–5.CrossRefPubMed
14.
go back to reference Doocy S, Lyles E, Roberton T, Akhu-Zaheya L, Oweis A, Burnham G. Prevalence and care-seeking for chronic diseases among Syrian refugees in Jordan. BMC Public Health. 2015;15(1):1097.CrossRefPubMedPubMedCentral Doocy S, Lyles E, Roberton T, Akhu-Zaheya L, Oweis A, Burnham G. Prevalence and care-seeking for chronic diseases among Syrian refugees in Jordan. BMC Public Health. 2015;15(1):1097.CrossRefPubMedPubMedCentral
16.
go back to reference Doocy S, Sirois A, Tileva M, Storey JD, Burnham G. Chronic disease and disability among Iraqi populations displaced in Jordan and Syria. Int J Health Plann Manage. 2013;28(1):e1–12.CrossRefPubMed Doocy S, Sirois A, Tileva M, Storey JD, Burnham G. Chronic disease and disability among Iraqi populations displaced in Jordan and Syria. Int J Health Plann Manage. 2013;28(1):e1–12.CrossRefPubMed
17.
18.
go back to reference Asfar T, Ahmad B, Rastam S, Mulloli TP, Ward KD, Maziak W. Self-rated health and its determinants among adults in Syria: a model from the Middle East. BMC Public Health. 2007;7:177.CrossRefPubMedPubMedCentral Asfar T, Ahmad B, Rastam S, Mulloli TP, Ward KD, Maziak W. Self-rated health and its determinants among adults in Syria: a model from the Middle East. BMC Public Health. 2007;7:177.CrossRefPubMedPubMedCentral
22.
go back to reference Lafta R, Al-Shatari S, Cherewick M, Galway L, Mock C, Hagopian A, Flaxman A, Takaro T, Greer A, Kushner A, Burnham G. Injuries, death, and disability associated with 11 years of conflict in Baghdad, Iraq: a randomized household cluster survey. PLoS One. 2015;10(8), e0131834.CrossRefPubMedPubMedCentral Lafta R, Al-Shatari S, Cherewick M, Galway L, Mock C, Hagopian A, Flaxman A, Takaro T, Greer A, Kushner A, Burnham G. Injuries, death, and disability associated with 11 years of conflict in Baghdad, Iraq: a randomized household cluster survey. PLoS One. 2015;10(8), e0131834.CrossRefPubMedPubMedCentral
26.
go back to reference Halasa Y, Nandakumar K. Factors determining choice of health care provider in Jordan. East Mediterr Health J. 2009;15(4):959–68.PubMed Halasa Y, Nandakumar K. Factors determining choice of health care provider in Jordan. East Mediterr Health J. 2009;15(4):959–68.PubMed
28.
go back to reference Shahin Y, Kapur A, Seita A. Diabetes care in refugee camps: the experience of UNRWA. Diabetes Res Clin Pract. 2015;108(1):1–6.CrossRefPubMed Shahin Y, Kapur A, Seita A. Diabetes care in refugee camps: the experience of UNRWA. Diabetes Res Clin Pract. 2015;108(1):1–6.CrossRefPubMed
Metadata
Title
Health service access and utilization among Syrian refugees in Jordan
Authors
Shannon Doocy
Emily Lyles
Laila Akhu-Zaheya
Ann Burton
Gilbert Burnham
Publication date
01-12-2016
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2016
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-016-0399-4

Other articles of this Issue 1/2016

International Journal for Equity in Health 1/2016 Go to the issue