Access of Syrian refugees to COVID-19 testing in Lebanon

Abstract

Background: Polymerase chain reaction is a well-known method for testing COVID-19 infection, however, refugee populations often face difficulties in accessing testing. Several structural and cultural challenges have hindered access of Syrian refugees to COVID-19 testing in Lebanon, including financial barriers, stigma, and low perception of vulnerability. Aims: To explore barriers to accessing COVID-19 testing by Syrian refugees in Lebanon. Methods: This qualitative study conducted 10 focus group discussions among Syrian refugees and 21 individual semi-structured interviews with healthcare workers. Ethical approval was obtained from the Institutional Review Board of the Lebanese International University, and the study followed the ethical principles of the Declaration of Helsinki. Results: Syrian refugees in Lebanon did not consider COVID-19 testing to be important. Despite the availability of free testing services, psychological, cultural, environmental, and financial barriers hindered them from getting tested. Some of them relied on consultation with pharmacists, who were easy to access and provided symptomatic treatment without the need to test for COVID-19. Fear of stigma, deportation, and isolation were common cultural barriers. Testing was considered unnecessary because of the perception of low disease severity and an attitude of negligence towards preventive practices. The harsh economic and living conditions were of greater concern to the refugees. Conclusion: Findings from this study adds to existing literature regarding the social and cultural barriers to COVID-19 testing among Syrian refugees and should be considered when tailoring health promotion campaigns to halt the spread of the COVID-19 pandemic.

Experiences of Cultural Differences, Discrimination, and Healthcare Access of Displaced Syrians (DS) in Lebanon: A Qualitative Study

“…This was closely linked to the poor living conditions of DS and the difficulty they had with self-isolation, while living in a tent crowded with big family members. This lines up with another study revealing how DS neglected preventive practices of COVID-19 due to their harsh living conditions [22].…”

Predicting COVID-19 Infection Among Older Syrian Refugees in Lebanon: A Multi-Wave Survey

“…Various obstacles to PCR testing at the individual, cultural, environmental, and financial levels were faced by Syrian refugees in Lebanon. 15 The barriers identified in this study and others were mainly related to individuals' perceptions of lack of need or lack of affordability, 15,26 despite the availability of free testing services and the national effort to raise awareness. 15 Perceived stigma, discrimination, fear of deportation, and limited accessibility to testing centers were reported as additional barriers to testing among Syrian refugees in Lebanon.…”

“…15 Perceived stigma, discrimination, fear of deportation, and limited accessibility to testing centers were reported as additional barriers to testing among Syrian refugees in Lebanon. 15 Given that nearly half of the participants visited doctors, healthcare services or pharmacies after getting infected, the implementation of COVID-19 screening in primary healthcare centers and pharmacies, could be an important strategy to control the spread of infection among Syrian refugees, as these settings are trusted sources and the front □ line of healthcare services. 15 In addition, in future pandemics, due to the use of non-prescribed medications and traditional remedies reported by older Syrian refugees, it will be important for humanitarian organizations to intensify their health promotion programs to increase awareness of testing availability and the importance of visiting a healthcare professional.…”

“…7 Despite their high susceptibility to COVID-19 infection, testing in this population has remained limited with a major barrier being lack of affordability. 15 Identifying those who have an increased susceptibility to infectious disease amongst vulnerable populations is important for future pandemics and outbreaks, of which displaced populations are at higher risk. Furthermore, prediction models developed to anticipate the risk of COVID-19 infection among refugees could support humanitarian organizations in efficiently identifying the most vulnerable groups, enabling them to provide essential assistance and prevent the occurrence of infections, as well as poor outcomes, while effectively allocating limited resources.…”

“…7 Despite their high susceptibility to COVID-19 infection, testing in this population has remained limited with a major barrier being lack of affordability. 15…”