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. 2016 Dec;6(2):020704.
doi: 10.7189/jogh.06.020704.

Health system resilience: Lebanon and the Syrian refugee crisis

Walid Ammar  1 , Ola Kdouh  2 , Rawan Hammoud  2 , Randa Hamadeh  2 , Hilda Harb  2 , Zeina Ammar  2 , Rifat Atun  3 , David Christiani  3 , Pierre A Zalloua  4
Affiliations

Health system resilience: Lebanon and the Syrian refugee crisis

Walid Ammar et al. J Glob Health. 2016 Dec.

Abstract

Background: Between 2011 and 2013, the Lebanese population increased by 30% due to the influx of Syrian refugees. While a sudden increase of such magnitude represents a shock to the health system, threatening the continuity of service delivery and destabilizing governance, it also offers a unique opportunity to study resilience of a health system amidst ongoing crisis.

Methods: We conceptualized resilience as the capacity of a health system to absorb internal or external shocks (for example prevent or contain disease outbreaks and maintain functional health institutions) while sustaining achievements. We explored factors contributing to the resilience of the Lebanese health system, including networking with stakeholders, diversification of the health system, adequate infrastructure and health human resources, a comprehensive communicable disease response and the integration of the refugees within the health system.

Results: In studying the case of Lebanon we used input-process-output-outcome approach to assess the resilience of the Lebanese health system. This approach provided us with a holistic view of the health system, as it captured not only the sustained and improved outcomes, but also the inputs and processes leading to them.

Conclusion: Our study indicates that the Lebanese health system was resilient as its institutions sustained their performance during the crisis and even improved.

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Figures

Figure 1
Figure 1
Hospital admissions by 2006–2014.
Figure 2
Figure 2
Utilization of hospital services in public hospitals 2010–2014.
Figure 3
Figure 3
Polio, DPT (diphtheria, pertussis and tetanus) and measles vaccination rates in Lebanon, 2009–2014.
Figure 4
Figure 4
Reported cases of tuberculosis in Lebanon among Lebanese and Non–Lebanese persons 2002 to 2014.
See this image and copyright information in PMC

References

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    1. UNCHR. Regional Public Health and Nutrition Strategy for Syrian Refugees EGYPT, IRAQ, JORDAN, LEBANON AND TURKEY 2014–2015. 2014. Available: http://reliefweb.int/report/syrian–arab–republic/regional–public–health–.... Accessed: 21 July 2014.