The impact of armed conflict on utilisation of health services in north-west Syria: an observational study

Abstract

Background Armed conflicts are known to have detrimental impact on availability and accessibility of health services. However, little is known on potential impact on utilisation of these services and health seeking behaviour. This study examines whether exposure to different types of war incidents affected utilisation of key health services—outpatient consultations, antenatal care, deliveries, and C-sections, in conflict affected areas of north west Syria between 1 October 2014 and 30 June 2017. Methods The study is an observational study using routinely collected data of 597,675 medical consultations and a database on conflict incidents that has 11,396 events. Longitudinal panel data analysis was used with fixed effect negative binomial regression for the monthly analysis and distributed lag model with a lag period of 30 days for the daily analysis. Results The study found strong evidence for a negative association between bombardments and both consultations and antenatal care visits. The monthly Risk Ratio was 0.95 (95% CI 0.94–0.97) and 0.95 (95% CI 0.93–0.98); and the cumulative daily RR at 30 days was 0.19 (95% CI 0.15–0.25) and 0.42 (95% CI 0.25–0.69) for consultations and antenatal care respectively. Explosions were found to be positively associated with deliveries and C-sections. Each one unit increase in explosions in a given month in a given village was associated with about 20% increase in deliveries and C-sections; RR was 1.22 (95% CI 1.05–1.42) and 1.96 (95% CI 1.03–3.74) respectively. Conclusion The study found that access to healthcare in affected areas in Syria during the study period has been limited. The study provides evidence that conflict incidents were associated negatively with the utilisation of routine health services, such as outpatient consultations and antenatal care. Whereas conflict incidents were found to be positively associated with emergency type maternity services—deliveries, and C-sections.

The Effect of War on Expaned Program on Immunization in North East Ethiopia, 2022

“…For the aforementioned reasons, mothers' engagement in preventive health services like immunization could decrease considerably. This nding is also supported by studies conducted in Yemen and Syria that noted a negative link between con ict and utilization of health services (20,21). This might be because of the economic, social, psychological, and other multifaceted effects of war which can hinder the population from preventive services like immunization.…”

“…Other studies also state the effect of protracted armed con ict in the health care utilization as the multifaceted effects of war on the population increase. studies conducted in Syria and other countries in the world support this nding (20,28).…”

Mental health of migrants with pre-migration exposure to armed conflict: a systematic review and meta-analysis

“…1 At the end of 2019, organised violence resulted in 76 480 fatalities 2 and a record-high 79•5 million forcibly displaced persons, 3 of whom 45•7 million are internally displaced people, 26•0 million are refugees, and 4•2 million are asylum seekers. 3 Besides experiencing sustained violence, people living in con flict territories also experience poverty, poor access to health care, 4 and food insecurity. 5 In addition to pre-migration stressors in countries of origin, migration and post-migration conditions in host countries pose sub stantial burdens for migrants exposed to armed conflict, which might lead to mental health disorders.…”

Face mediated human–robot interaction for remote medical examination

“…Viewing the patient’s facial expressions during this manual palpation provides a critical source of feedback to assess a range of medical hypotheses for diagnosis. Given the growing shortage of physicians 14 , the chronic issues such as pandemics 15 – 17 , cost and time cost involved in face-to-face examinations 18 , inaccessibility to examine the patients due to issues such as armed conflicts 19 , the need for remote diagnosis of patients has gained much attention in recent times. Remote palpation examination is one such approach that is growing in interest for remote diagnosis.…”

“…Physical examinations are often performed in-person. However, with the growing shortage of physicians 14 and the considerable challenges of conducting in-person patient examination due to global issues such as pandemics 15 – 17 , the time cost involved in face-to-face examinations 18 , and inaccessibility to examine the patients due to issues such as armed conflicts 19 , the need for remote diagnosis of patients has gained much attention in recent times. Further, remote diagnosis and treatment reduces the burden on hospitals and the risk of cross-infection during pandemics 20 .…”