Impact of restricting access to health care services on Syrian refugees in Jordan: evidence from cross-sectional surveys

Abstract

Purpose Access to health-care services for refugees are always impacted by many factors and strongly associated with population profile, nature of crisis and capacities of hosing countries. Throughout refugee’s crisis, the Jordanian Government has adopted several healthcare access policies to meet the health needs of Syrian refugees while maintaining the stability of the health-care system. The adopted health-care provision policies ranged from enabling to restricting and from affordable to unaffordable. The purpose of this paper is to identify the influence of restricted level of access to essential health services among Syrian refugees in Jordan. Design/methodology/approach This paper used findings of a cross-sectional surveys conducted over urban Syrian refugees in Jordan in 2017 and 2018 over two different health-care access policies. The first were inclusive and affordable, whereas the other considered very restricting policy owing to high inflation in health-care cost. Access indicators from four main thematic areas were selected including maternal health, family planning, child health and monthly access of household. A comparison between both years’ access indicators was conducted to understand access barriers and its impact. Findings The comparison between findings of both surveys shows a sudden shift in health-care access and utilization behaviors with increased barriers level thus increased health vulnerabilities. Additionally, the finding during implementation of restricted access policy proves the tendency among some refugees groups to adopt negative adaptation strategies to reduce health-care cost. The participants shifted to use a fragmented health-care, reduced or delayed care seeking and use drugs irrationally weather by self-medication or reduce drug intake. Originality/value Understanding access barriers to health services and its negative short-term and long-term impact on refugees’ health status as well as the extended risks to the host communities will help states that hosting refugees building rational access policy to protect whole community and save public health gains during and post crisis. Additionally, it will support donors to better mobilize resources according to the needs while the humanitarian actors and service providers will better contribute to the public health stability during refugee’s crisis.

Making an economic argument for investment in global mental health: The case of conflict-affected refugees and displaced people

“…Elsewhere, other analyses looking at Somali refugees in the UK (McCrone et al, 2005 ), Syrian refugees in Turkey (Fuhr et al, 2019 ; Acarturk et al, 2022 ) and internally displaced people in Georgia (Chikovani et al, 2015 ) all report low levels of contact with mental health services despite mental health needs. While economic evidence on the association between restricted access to health services and longer-term mental health outcomes appears limited in LMICS, reduced, potentially inadequate, levels of contact with services will occur when out of pocket costs and other barriers to service use are introduced, as for instance seen in Jordan after the costs of access to health services for Syrian refugees rose (Abu Siam and Rubio Gómez, 2021 ). These examples of low utilisation of services potentially could increase future risk of more intensive need for health service use.…”